Multiresistant tuberculosis in the Zurich Höhenklinik Wald from 1984 to 1992

: Out of a total of 386 patients with culture-proven tuberculosis, ten cases of multidrug-resistant tuberculosis were treated in a high altitude chest clinic in Switzerland between 1984 and 1992. Two patients, Swiss, were alcoholics, the other eight foreigners. None of the patients were HIV-positive. Both Swiss had primary INH resistance, then developed secondary INH/RMP resistance due to poor compliance. All patients were treated with at least two additional in-vitro-sensitive drugs as well as with INH. Five patients underwent resection of lung parenchyma. One of these patients has had three operations and remains the sole therapy failure. One patient died before an operation could be performed. All others are well. Possible reasons for multidrug-resistance and the management of the ten cases are discussed in accordance with the literature.