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  1. The Triumvirate

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Post Brexit Blues—Building Strong Links Across the UK, EU and Beyond…

The Baltic states have seen big improvements in the quality of health care, and TB in particular in recent years. Whether this is due to membership of the EU is not certain, but the temporal relationship does support this hypothesis. However they still have a considerable problem with multi-drug, and extremely drug resistant TB. In this issue of Thorax, Balabanova and colleagues describe the experience of Eastern Europe dealing with MDR and XDR-TB (see page 854). Not surprisingly, older age, and co-infection with HIV worsen outcomes but at least fluorquinolones and injectable anti-tuberculous therapy appeared to be effective in a substantial proportion of patients.

The Canadian model of trade with the EU has been postulated as one of the post-BREXIT options. Maybe the UK can also learn about off-label use of inhaled Tobramycin, it seems that in Canada the large increase in inhaled Tobramycin use is due to off-label prescriptions for patients with COPD …

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