The global tuberculosis epidemic will result in an estimated 90 million new cases and 30 million deaths during the current decade.<sup>44 Raviglione M.C., Snider D.E., Kochi A. Global epidemiology of tuberculosis: Morbidity and mortality of a worldwide epidemic JAMA 1995 ;  273 : 220-226

Cliccare qui per andare alla sezione Riferimenti</sup> Programmatic control of this devastating epidemic and clinical management of individual cases has been complicated in recent years by the widespread emergence of drug-resistant Mycobacterium tuberculosis. Rates of infection caused by multidrug-resistant (MDR) organisms, defined as resistance to at least isoniazid and rifampin, have reached critical levels in many areas of the United States and the world.<sup>5 Bloch A.B., Cauthen G.M., Onorato I.M. , e al. Nationwide survey of drug-resistant tuberculosis in the United States JAMA 1994 ;  271 : 665-671

Cliccare qui per andare alla sezione Riferimenti, 14 Cohn D.L., Bustreo F., Raviglione M.C. Drug-resistant tuberculosis: Review of the worldwide situation and the WHO/IUATLD Global Surveillance Project: International Union Against Tuberculosis and Lung Disease Clin Infect Dis 1997 ;  24 (suppl 1) : S121-S130

Cliccare qui per andare alla sezione Riferimenti</sup> These cases of multidrug-resistant tuberculosis are associated with significantly higher rates of morbidity and mortality, and successful treatment typically necessitates prolonged courses of chemotherapy, measures to ensure patient adherence, and considerations of resectional surgery.<sup>23 Goble M., Iseman M.D., Madsen L.A. , e al. Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin N Engl J Med 1993 ;  328 : 527-532  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Programmatic resources to address this emerging public health problem are frequently inadequate in the areas most profoundly affected by the epidemic.