Isolated resistance to PZA or EMB is rare. Isolated PZA resistance occurs genotypically in M. bovis.12 In 2003, PZA mono-resistance was reported in isolates of M. tuberculosis from Quebec.84 Patients with these strains had worse clinical outcomes than those with fully susceptible strains.85 In patients with disease due to PZA-resistant isolates, the total duration of treatment should be 9 months or more. EMB mono-resistance will not change the efficacy or duration of treatment with standard regimens (see Table 4).56,86
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