[Drug resistance in tuberculosis].
BACKGROUND
The emergence of drug-resistant tuberculosis is one of the main challenges in the global combat against tuberculosis. The objective of the article is to discuss the main causes for emergence of drug resistance, describe the epidemiology of drug-resistant tuberculosis with focus on the situation in Norway and advise on how this should be managed.


METHODS
This review is based on relevant published literature, data from surveillance of the disease in Norway and current national and international recommendations for prevention and control of tuberculosis.


RESULTS
Tuberculosis can normally be treated effectively with a standardized combination of drugs for six months. The long duration of treatment is a challenge and incorrect treatment causes development of resistant tuberculosis. The objectives of tuberculosis treatment are to cure the patient, to stop transmission of the bacteria and prevent emergence of drug resistance. The total number of patients diagnosed with multidrug resistant tuberculosis (MDR)-TB in Norway is low, although a threefold increase has occurred in the last decade compared to in previous decades. Most patients were born abroad. Treatment of MDR-TB takes up to two years, is costly and has more side effects. Treatment of MDR-TB is associated with lower cure rate and higher fatality; although in Norway most cases are cured.


CONCLUSIONS
The global situation also affects Norway. Early diagnosis of infectious cases and close monitoring of patients under treatment, by direct observation of medication, can prevent new cases of MDR-TB.
Winje
Brita Askeland
BA
Avdeling for infeksjonsovervåking, Nasjonalt folkehelseinstitutt, Postboks 4404 Nydalen, 0403 Oslo. brita.winje@fhi.no
Mannsåker
Turid
T
Langeland
Nina
N
Heldal
Einar
E
D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects; D003140:Communicable Disease Control; D024881:Drug Resistance, Bacterial / Q000235:genetics; D014943:Global Health; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics; D009664:Norway / Q000453:epidemiology; D011634:Public Health; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
D000995:Antitubercular Agents