D A Mitchison1. 1. Department of Medical Microbiology, St. George's Hospital Medical School, London, UK. dmitchis@sghms.ac.uk
Abstract
OBJECTIVE: To explore mechanisms by which drug resistance might arise as a result of poor compliance during short course chemotherapy. DESIGN: Four theoretical mechanisms are first described. RESULTS: Examples of the way the mechanisms probably operate are taken from: 1) a study of once-weekly chemotherapy with streptomycin and isoniazid, and 2) the pattern of drug susceptibility in cultures from patients who relapsed after the end of treatment. CONCLUSION: Good compliance is vitally important. The value of a fourth drug in the initial phase of chemotherapy in preventing resistance is questioned. An explanation for mono-resistance to rifampicin in patients with the acquired immune deficiency syndrome (AIDS) is suggested.
OBJECTIVE: To explore mechanisms by which drug resistance might arise as a result of poor compliance during short course chemotherapy. DESIGN: Four theoretical mechanisms are first described. RESULTS: Examples of the way the mechanisms probably operate are taken from: 1) a study of once-weekly chemotherapy with streptomycin and isoniazid, and 2) the pattern of drug susceptibility in cultures from patients who relapsed after the end of treatment. CONCLUSION: Good compliance is vitally important. The value of a fourth drug in the initial phase of chemotherapy in preventing resistance is questioned. An explanation for mono-resistance to rifampicin in patients with the acquired immune deficiency syndrome (AIDS) is suggested.
Authors: Christian Munck; Heidi K Gumpert; Annika I Nilsson Wallin; Harris H Wang; Morten O A Sommer Journal: Sci Transl Med Date: 2014-11-12 Impact factor: 17.956
Authors: Helen S Cox; Cheryl McDermid; Virginia Azevedo; Odelia Muller; David Coetzee; John Simpson; Marinus Barnard; Gerrit Coetzee; Gilles van Cutsem; Eric Goemaere Journal: PLoS One Date: 2010-11-15 Impact factor: 3.240