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Role of surgery in pulmonary multidrug-resistant tuberculosis
  1. L Peter Ormerod
  1. Correspondence to:
    Professor L P Ormerod
    Chest Clinic, Royal Blackburn Hospital, Blackburn, Lancashire BB2 3HH, UK; Peter.Ormerod{at}

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Feasible in the context of a good national programme in resource-limited settings, but doubts remain over how widely this may be able to be implemented

Multidrug-resistant tuberculosis (MDR-TB) is a form of TB with high level resistance to both isoniazid and rifampicin, with or without associated resistance to other antituberculosis drugs. The spectrum of this form of TB now ranges from “basic” MDR-TB, with resistance only to rifampicin and isoniazid, to XDR-TB where there is additional extensive drug resistance to at least three of the six main classes of second-line antituberculosis drugs.1 The extent of the problem of MDR-TB has been examined by cross-sectional surveys of drug resistance either in clinical series or whole country cohorts by the World Health Organisation (WHO).2 Such cross-sectional surveys, however, underestimate the burden and number of such cases because they do not take into account the amount of TB in high-burden countries. If the exercise is repeated …

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