Regimens to treat multidrug-resistant tuberculosis: past, present and future perspectives

Eur Respir Rev. 2019 May 29;28(152):190035. doi: 10.1183/16000617.0035-2019. Print 2019 Jun 30.


Over the past few decades, treatment of multidrug-resistant (MDR)/extensively drug-resistant (XDR) tuberculosis (TB) has been challenging because of its prolonged duration (up to 20-24 months), toxicity, costs and sub-optimal outcomes.After over 40 years of neglect, two new drugs (bedaquiline and delamanid) have been made available to manage difficult-to-treat MDR-/XDR-TB cases. World Health Organization (WHO) guidelines published in March 2019 endorsed the possibility of treating MDR-TB patients with a full oral regimen, following previous guidelines published in 2016 which launched a shorter regimen lasting 9-10 months.The objectives of this article are to review the main achievements in MDR-TB treatment through the description of the existing WHO strategies, to discuss the main ongoing trials and to shed light on potential future scenarios and revised definitions necessary to manage drug-resistant TB.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Antitubercular Agents / administration & dosage*
  • Antitubercular Agents / history
  • Diffusion of Innovation
  • Drug Administration Schedule
  • Drug Resistance, Multiple, Bacterial*
  • Drug Therapy, Combination
  • Extensively Drug-Resistant Tuberculosis / drug therapy
  • Extensively Drug-Resistant Tuberculosis / history
  • Extensively Drug-Resistant Tuberculosis / microbiology
  • Forecasting
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / history
  • Tuberculosis, Multidrug-Resistant / microbiology


  • Antitubercular Agents