Management of multidrug-resistant tuberculosis in the 21st century.

The spread of drug-resistant tuberculosis (TB) continues to be a global health crisis with increasing cases of multidrug-resistant TB (MDR-TB) being diagnosed worldwide. The identification and clinical management of MDR-TB is associated with additional problems related to resistance, diagnosis and treatment as compared to drug-susceptible TB. Treatment of MDR-TB usually involves therapy with long regimens of second-line drugs up to 24 months resulting in higher risks of serious adverse effects, lack of compliance and heightened economic burden on the patients. Issues such as increasing transmission of drug-resistant strains, poor diagnostic coverage and lengthy, toxic treatments need to be overcome by innovative approaches such as quick diagnostic tools and shorter drug regimens as already recommended by the World Health Organization (WHO) in its 2018 Global Tuberculosis Report. This review highlights the challenges being faced by clinicians worldwide in the diagnosis and treatment of MDR-TB.

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