Treating pyrazinamide mono-resistant pulmonary tuberculosis [Correspondence]

The standard short-course chemotherapy regimen is highly effective for treating pulmonary tuberculosis (PTB), but in patients harboring mono-resistant strains of Mycobacteriunt tuberculosis this regimen favors treatment failure and further acquired resistance. super(1) The World Health Organization (WHO) indicates that such patients may require modifications to the regimen, but acknowledges that its recommendations 'are based on evidence from the pre-rifampicin era, observational studies, general principles of microbiology and therapeutics in TB, extrapolations from established evidence and expert opinion'. super(1) Likewise, in its recently issued guidelines, the International Union Against Tuberculosis and Lung Disease warns that the best approach (drug combination and treatment duration) for dealing with a patient's resistance pattern is still debatable. super(2) An urgent need thus remains to gain experience in the treatment of mono-resistant PTB patients. Here we describe the outcomes of the management of patients with newly diagnosed PTB caused by strains of M. tuberculosis with pyrazinamide monoresistance (PZA super(MR)).