Among patients with no prior treatment, a median of 9.9 percent of M. tuberculosis strains were resistant to at least one drug. Among patients with histories of treatment for one month or less, the prevalence of resistance to any of the four drugs was 36 percent, and the prevalence of multidrug resistance was 13 percent. Particularly high prevalences of multidrug resistance were found in the former Soviet Union, Asia, the Dominican Republic, and Argentina. The authors conclude that resistance to antituberculosis drugs exists in all 35 countries and regions surveyed, and they suggest that it is a global problem. Antibiotic resistance, initially a problem in hospitals and developing countries, today affects the world at large.
Resistance is progressive, evolving from low levels through intermediate to high levels.
Once resistance appears, it is likely to decline slowly, if at all. The use of antibiotics by one person affects others in the extended as well as immediate environment. Stuart B. Levy, Tufts Univ. During the last decade there has been an alarming increase in the appearance of antibiotic-resistant bacteria as a result of an increased use of antibiotics combined with the exceptional ability of bacteria to develop resistance. One strategy to reverse this development is to decrease the use of antibiotics to promote the disappearance of the resistant bacteria present in human and environmental reservoirs.