Editing Tuberculosis (section)

=== Drug resistant tuberculosis ===
However, a few years after  the first antibiotic [[Tuberculosis management|treatment]] for TB in 1943, some strains of the TB bacteria developed resistance to the standard drugs (streptomycin, [[4-Aminosalicylic acid|para-aminosalicylic acid]], and [[isoniazid]]).<ref name="Keshavjee-2012">{{Cite journal |last1=Keshavjee |first1=Salmaan |last2=Farmer |first2=Paul E. |date=2012-09-06 |title=Tuberculosis, Drug Resistance, and the History of Modern Medicine |url=http://www.nejm.org/doi/10.1056/NEJMra1205429 |journal=New England Journal of Medicine |language=en |volume=367 |issue=10 |pages=931–936 |doi=10.1056/NEJMra1205429 |pmid=22931261 |issn=0028-4793}}</ref> Between 1970 and 1990, there were numerous outbreaks of drug-resistant tuberculosis involving strains resistant to two or more drugs; these strains are called [[Multidrug-resistant tuberculosis|multi-drug resistant TB]] (MDR-TB).<ref name="Keshavjee-2012" /> The resurgence of tuberculosis, caused in part by drug resistance and in part by the [[Epidemiology of HIV/AIDS|HIV pandemic]],  resulted in the declaration of a global health emergency by the World Health Organization (WHO) in 1993.<ref>{{cite journal |vauthors=Chaisson RE, Frick M, Nahid P |date=March 2022 |title=The scientific response to TB - the other deadly global health emergency |journal=The International Journal of Tuberculosis and Lung Disease |volume=26 |issue=3 |pages=186–189 |doi=10.5588/ijtld.21.0734 |pmc=8886961 |pmid=35197158}}</ref><ref>{{Cite journal |date=July–August 1993 |title=Tuberculosis : a global emergency |url=https://iris.who.int/handle/10665/52639 |journal=World Health |volume=46 |issue=4 |pages=3–31}}</ref>

Treatment of MDR-TB requires treatment with [[Tuberculosis management#Second line|second-line drugs]], which in general are less effective, more toxic and more expensive than first-line drugs.<ref>{{Cite journal |last1=Millard |first1=James |last2=Ugarte-Gil |first2=Cesar |last3=Moore |first3=David A. J. |date=2015-02-26 |title=Multidrug resistant tuberculosis |url=http://www.bmj.com/content/350/bmj.h882 |journal=BMJ |volume=350 |pages=h882 |doi=10.1136/bmj.h882 |issn=1756-1833 |pmid=25721508 |s2cid=11683912}}</ref> Treatment regimes can run for two years, compared to the six months of first-line drug treatment.<ref>Kaplan, Jeffrey. 2017. "Tuberculosis" American University. Lecture.</ref><ref name="accessmedicine.mhmedical.com">{{cite book |last1=Adams and Woelke |url=http://accessmedicine.mhmedical.com/content.aspx?bookid=710&Sectionid=46796911 |title=Understanding Global Health. Chapter 10: TB and HIV/AIDS |date=2014 |publisher=McGraw Hill |edition=12th |access-date=9 May 2015}}</ref>