A new era for treatment of drug-resistant tuberculosis

For three decades, drug-resistant tuberculosis (TB) has posed grave challenges to patients, communities and global TB control efforts. Treatment of multidrug-resistant (MDR)-TB (i.e. TB resistant to at least isoniazid and rifampicin) and extensively drug-resistant (XDR)-TB (i.e. MDR-TB with additional resistance to fluoroquinolones and second-line injectable TB drugs) has relied on medications that are less potent and more toxic than first-line TB therapy. Consequently, drug-resistant TB treatment takes 2 years to complete and has been associated with frequent and severe side-effects. Treatment outcomes remain abysmal despite this prolonged therapy, with only 54% of MDR-TB patients and 30% of XDR-TB patients achieving cure [1]. When considering the full cascade of individuals estimated to have drug-resistant TB, only 12% of MDR-TB and 6.8% of XDR-TB patients are cured (figure 1) Adoption of new treatment regimens for drug-resistant TB has been slowed amid concerns regarding their efficacy and safety. Numerous studies worldwide now provide substantial evidence to support widespread implementation of these new drugs and regimens. http://ow.ly/FX8I30lpANX