Abstract Antimicrobial resistance (AMR) in Mycobacterium tuberculosis (Mtb) represents a major obstacle to effective tuberculosis (TB) control worldwide. This paper examines the mechanisms, challenges, and emerging strategies associated with drug-resistant TB. Resistance in Mtb arises through genetic mutations and adaptive mechanisms that reduce drug susceptibility, contributing to the emergence of multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB). In addition, bacterial survival strategies such as metabolic adaptation and drug tolerance further complicate treatment (Datta et al., 2024). The growing burden of resistant TB is intensified by inadequate diagnostic tools, prolonged and toxic treatment regimens, and limited healthcare access, particularly in low- and middle-income countries (Okeke et al., 2024). Socioeconomic factors and healthcare disparities further facilitate the transmission and persistence of resistant strains (Jin et al., 2024). Recent advances in molecular diagnostics, including rapid resistance detection techniques, have improved early diagnosis and treatment personalization (Xiong et al., 2024). Moreover, the development of novel drugs and combination therapies offers promising solutions for overcoming resistance (Patel et al., 2025). Addressing AMR in TB requires integrated approaches involving early detection, effective treatment strategies, and strengthened public health systems.
Nagaraju Koppu (Thu,) studied this question.