Based on these data, increased efforts in education, testing, and prevention are being targeted towards the groups at highest risk for infection with TB. . Consolidation of testing in one lab has resulted in increased consistency and quality, and assisted in epidemiologic linking of results. This advantage is especially important when the organisms are drug resistant. Use of DOT and full cooperation with treatment has resulted in fewer patients with persistently positive cultures, a greater percentage of persons completing treatment, and a reduction in multiple drug- resistant cases both in Westchester County and elsewhere. Because rifampin decreases plasma levels and efficacy of protease inhibitors, concurrent therapy with rifampin and protease inhibitors is contraindicated.
Expert consultation is advised.