Management of drug-resistant tuberculosis

The emergence and spread of drug-resistant strains of Mycobacterium tuberculosis (M. tuberculosis) have become tremendous challenges for clinical and programmatic tuberculosis (TB) management. Until recently, TB diagnosis was largely based on 120-year-old smear microscopy, and treatment was based on a limited number of drugs developed prior to 1970. During the past few years, we have witnessed a revolution in the ability of laboratories to detect TB and anti-TB drug resistance. Furthermore, after several years of silence, several new anti-TB drugs have recently appeared on the scene, offering hope for patients with very limited therapeutic options. There is also new evidence supporting the appropriate use of existing drugs in the treatment of MDR-TB and a better understanding of the relevance of additional resistance beyond extensive drug resistance patterns. In this article, we review the management of drug-resistant TB and highlight recent developments concerning its diagnosis and treatment.