Drug-Resistant Tuberculosis

The article, “Primary Drug-Resistant Tuberculosis” by Steiner et al. (N Engl J Med 283:1353–1358, 1970), should abolish any doubts that still exist about the ability of drug-resistant strains of Mycobacterium tuberculosis hominis to cause infection and progressive disease in human beings. It is known that children who have complicated pulmonary tuberculosis caused by infection with streptomycin-resistant tubercle bacilli and who have been treated only with streptomycin generally have a progressive downhill course.1 However, there has been considerable controversy over the role of isoniazid (INH)-resistant strains since the clinical course in patients infected with such strains and treated.