Tuberculosis treatment and management--an update on treatment regimens, trials, new drugs, and adjunct therapies

Lancet Respir Med. 2015 Mar;3(3):220-34. doi: 10.1016/S2213-2600(15)00063-6. Epub 2015 Mar 9.


WHO estimates that 9 million people developed active tuberculosis in 2013 and 1·5 million people died from it. Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis continue to spread worldwide with an estimated 480,000 new cases in 2013. Treatment success rates of MDR and XDR tuberculosis are still low and development of new, more effective tuberculosis drugs and adjunct therapies to improve treatment outcomes are urgently needed. Although standard therapy for drug-sensitive tuberculosis is highly effective, shorter, more effective treatment regimens are needed to reduce the burden of infectious cases. We review the latest WHO guidelines and global recommendations for treatment and management of drug-sensitive and drug-resistant tuberculosis, and provide an update on new drug development, results of several phase 2 and phase 3 tuberculosis treatment trials, and other emerging adjunct therapeutic options for MDR and XDR tuberculosis. The use of fluoroquinolone-containing (moxifloxacin and gatifloxacin) regimens have failed to shorten duration of therapy, and the new tuberculosis drug pipeline is sparse. Scale-up of existing interventions with increased investments into tuberculosis health services, development of new antituberculosis drugs, adjunct therapies and vaccines, coupled with visionary political leadership, are still our best chance to change the unacceptable status quo of the tuberculosis situation worldwide and the growing problem of drug-resistant tuberculosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adjuvants, Immunologic / therapeutic use*
  • Anti-HIV Agents / therapeutic use
  • Antitubercular Agents / therapeutic use*
  • Clinical Protocols
  • Coinfection / complications
  • Coinfection / drug therapy
  • Drug Discovery
  • Drug Therapy, Combination
  • Global Health
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • Humans
  • Mycobacterium tuberculosis
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Tuberculosis, Multidrug-Resistant / complications
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • World Health Organization


  • Adjuvants, Immunologic
  • Anti-HIV Agents
  • Antitubercular Agents