Drug resistance in children with tuberculosis is usually primary (transmitted); however, resistance acquisition during treatment is possible. We describe a child with tuberculosis who acquired drug resistance while receiving directly observed but inadequate first-line therapy and the programmatic and clinical factors that may have contributed to resistance acquisition.
From the *Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg; †Brooklyn Hospital for Chest Diseases, Cape Town; ‡Division of Pharmacology; §Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, MRC Centre for Molecular and Cellular Biology, Stellenbosch University; and ¶Tygerberg Children’s Hospital, Tygerberg, South Africa.
Accepted for publication March 5, 2014.
The authors have no funding or conflicts of interest to disclose.
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Address for correspondence: Anthony J. Garcia-Prats, MD, Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Clinical Building, Room 0085, Faculty of Health Sciences, Stellenbosch University, P.O. Box 19063, Tygerberg, South Africa. E-mail: firstname.lastname@example.org.