Drug-resistant tuberculosis: Promising progress with a note of caution

The management of drug-resistant tuberculosis (DR-TB) has been a formidable challenge for patients, healthcare providers and public health systems for many years. In particular, for multidrug-resistant TB (MDR-TB), resistant to both rifampicin and isoniazid, the available treatments have historically been prolonged, toxic, of poor efficacy, with a limited evidence base and often requiring an expensive individualized hospital-based approach. However, in recent times, many of these challenges have begun to be addressed. New drugs and a strengthening evidence base are enabling the development of shorter, more effective regimens with the potential for easy programmatic translation. Diagnostics have been revolutionized by the widespread introduction of molecular testing and care is being increasingly decentralized away from the few specialist centres. This progress has…