title: Brazilian experience in the management of multidrug-resistance.
abstract: In this article the author reviews the evolution of the approach to multidrug-resistant tuberculosis (MDR-TB) in Brazil following the introduction of rifampicin associated to isoniazid and pyrazinamide (RHZ). It shows Brazil was one of the world's first countries to use the RHZ regimen within a treatment system, with a first line regimen, another one specific for meningo-encephalic forms, for re-treatment of recurrences or of patients who returned with active tuberculosis after abandoning treatment, and a reserve regimen. The system was applied nationwide with guaranteed cost-free provision of medication, and self-administered. The author evaluates the growth of drug resistance, the emergence of multidrug-resistance and how management of this form of the disease has been organised.
authors.affiliation: Médico, Diretor do Instituto Clemente Ferreira - Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo - ICF/CCD/SES-SP/Physician, Director, Instituto Clemente Ferreira, Coordinator of Disease Control of the Secretary of State for Health of São Paulo - ICF/CCD/SES-SP Doutorado em Medicina, área de pneumologia, pela Escola Paulista de Medicina da Universidade Federal de São Paulo - EPM/UNIFESP/PhD, Pulmonology, Escola Paulista de Medicina da Universidade Federal de São Paulo - EPM/UNIFESP. Electronic address: fernandofiuza@terra.com.br.
authors.forename: Fernando Augusto Fiuza
authors.initials: FA
authors.lastname: de Melo
keywords: Multidrug-resistant tuberculosis (MDR-TB); Tuberculose multirresistente a múl-tiplos medicamentos (TB-MDR); extensively drug-resistant; tuberculose super-resistente (TB-XDR); tuberculosis (XDR-TB)