Antibiotic drug-resistant tuberculosis

Tuberculosis remains to be one of the most important infectious diseases worldwide. Among the estimated 9 million new cases that are anually recorded, antibiotic drug resistance of Mycobacterium tuberculosis has become an increasing problem. Cases of multidrug resistance (MDR), by definition resistance against at least isoniazid and rifampin, are reported worldwide. Moreover, cases of extensively drug-resistant tuberculosis (XDR-TB) with additional resistance to fluoroquinolones and aminoglycosides are also emerging. Patients who are infected with MDR-TB strains need a carefully selected antibiotic combination therapy consisting of four to six alternative drugs according to the results of in vitro drug susceptibility testing. The duration of treatment against MDR-TB is cost-intensive, and is generally recommended for 18 months beyond the first time of sustained culture negativity. Patient adherence to the therapy is essential. As adverse effects of MDR-TB therapy are common, treatment of these patients should be guided by experienced physicians.