Diagnosis and treatment of multidrug-resistant tuberculosis
Open accessAbstract
Tuberculosis (TB) is still a major health problem worldwide. Especially, multidrug-resistant TB (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, is a barrier in the treatment of TB. Globally, approximately 3.4% of new TB patients and 20% of the patients with a history of previous treatment for TB were diagnosed with MDR-TB. The treatment of MDR-TB requires medications for a long duration (up to 20-24 months) with less effective and toxic second-line drugs and has unfavorable outcomes. However, treatment outcomes are expected to improve due to the introduction of a new agent (bedaquiline), repurposed drugs (linezolid, clofazimine, and cycloserine), and technological advancement in rapid drug sensitivity testing. The World Health Organization (WHO) released a rapid communication in 2018, followed by consolidated guidelines for the treatment of MDR-TB in 2019 based on clinical trials and an individual patient data meta-analysis. In these guidelines, the WHO suggested reclassification of second-line anti-TB drugs and recommended oral treatment regimens that included the new and repurposed agents. The aims of this article are to review the treatment strategies of MDR-TB based on the 2019 WHO guidelines regarding the management of MDR-TB and the diagnostic techniques for detecting resistance, including phenotypic and molecular drug sensitivity tests.
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Treatment typically involves standard antitubercular therapy, which is effective in most cases, although multidrug-resistant TB can complicate treatment.
“Treatment typically involves standard antitubercular therapy, which is effective in most cases, although multidrug-resistant TB can complicate treatment [32,33,34].”
From Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease (2025) · cites this paper as [34]
The Introduction (page unavailable) says MDR-TB resists two of the most effective anti-TB drugs and requires longer, less effective second-line treatment, supporting the claim that resistance complicates treatment. The paper does not establish that standard antitubercular therapy is effective in most TB cases. (LLM, conf=0.86)
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- Authors
- Jang, J. G., & Chung, J. H.
- Affiliations
- Yeungnam University Medical Center (KR)
- Corresponding author
- Chung, Jin Hong
- Venue
- Yeungnam University Journal of Medicine
- Published
- 2020-10-31
- Volume
- 37
- Issue
- 4
- Pages
- 277-285
- ISSN
- 1225-7737 (ISSN-L)
- 2384-0293
- PMC
- PMC7606956
- OpenAlex
- W3083676524
- Cited by
- 140
- References
- 46
- Citations by year
- 2026: 15 · 2025: 36 · 2024: 42 · 2023: 30 · 2022: 7 · 2021: 9 · 2020: 1
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Journal of Yeungnam Medical Science (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
- Keywords
- multidrug-resistant tuberculosis, isoniazid resistance, rifampicin resistance, second-line antituberculosis drugs, bedaquiline, linezolid, clofazimine, cycloserine, drug repurposing, phenotypic drug susceptibility testing
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