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Ninety adolescents suffering from tuberculosis with primary drug resistance (PDR) in Mycobacterium tuberculosis (MBT) were followed up. All the patients had active, marked processes, mainly infiltrative tuberculosis in the phase of decay and dissemination. MBT resistance to 3 drugs or more was detected in most patients (62.3%). Multidrug resistance was 32.2%. The course of the disease was chiefly favorable. An exacerbation of the process occurred during therapy in 6.6% of patients. In patients with PDR, abacillation occurred in 100% of cases and the decay cavities closed in 86.6% by the end of the course of therapy. The PDR patients received treatment with both first- and second-line drugs, had surgery, collapsotherapy, laser therapy, and physiotherapeutic treatments, and lidase. Treatment of patients with drug-resistant tuberculosis presents severe difficulties. However, good results can be achieved in most patients, by applying an individual approach to each patient and determining the optimum chemotherapy regimens and pathogenetic treatments.

The authors analyse the data obtained on 366 tuberculous adolescents treated in the central Research Institute of Tuberculosis in 1989-1990. Active disease occurred in 30% of them. As evident from larger proportion of infiltrative tuberculosis with destruction and dissemination, the incidence rate of which had grown from 11.5% in 1989 to 40% in 1992 and of caseous pneumonia (the growth, respectively, from 7.7% in 1990 to 25% in 1992), clinical patterns of tuberculosis takes a more serious course. Of late, caseous pneumonia in adolescents has been characterized by an acute onset, loss of weight against severe intoxication, pronounced bacterial discharge, shifts in blood and immunity indices, associated affections. Most of the adolescents were infected in their family who had failed to receive BCG revaccination. Adequate combined treatment has resulted in favourable outcomes which, however, have been often accompanied by defective healing.