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U.S. Department of Health and Human Services


TB Facts for Health Care Workers

Multidrug-Resistant Tuberculosis (MDR TB)

An extremely serious aspect of the TB problem in the United States is MDR TB (i.e., TB caused by organisms resistant to at least isoniazid and rifampin, the two most important anti-TB drugs). MDR TB can usually be prevented by initially treating TB patients with four drugs and by administering TB medications on a directly observed basis. Persons at high risk for MDR TB include persons who have been recently exposed to MDR TB, especially if they are immunocompromised; TB patients who failed to take medications as prescribed; TB patients who were prescribed an ineffective treatment regimen; and persons previously treated for TB.

MDR TB presents difficult treatment problems. Treatment must be individualized and based on the patientís medication history and drug susceptibility study results. Clinicians who are not expert with the management of patients with MDR TB disease or with patients infected with multidrug-resistant organisms should seek expert consultation. Contact your state health department TB program or your Regional Training and Medical Consultation Center (COE). Contact information for the COEs is located at the back of this booklet.

The risk for progression to TB disease should be considered before recommending treatment for LTBI. Alternative regimens should consist of drugs to which the infecting organism has demonstrated susceptibility. A potential regimen includes daily fluoroquinolone, an antibiotic, for 6-12 months.

Contacts may be treated for 6 months or observed without treatment. Immunocompromised contacts (e.g., persons who are HIV infected) should be treated for 12 months. All persons with suspected MDR LTBI should be followed for 2 years regardless of the treatment regimen.


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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