How to Design the Regimen for Drug-Resistant Tuberculosis (and Clinical Cases)

Rifampicin-resistant tuberculosis (RR-TB) and multidrug-resistant tuberculosis (MDR-TB) are characterised by higher rates of mortality, complexity and resource utilisation. There were an estimated half million cases of these drug-resistant forms of tuberculosis in 2018, with 186,772 cases being notified and only 156,701 started on treatment. Within the last decade the use of repurposed and new MDR-TB drugs have been assessed and optimised with a reduction of poorer outcomes including death and better regimen tolerability. Newer all-oral shorter treatment regimens are now being recommended and implemented worldwide, in the hope all MDR-TB patients can be treated and the gap can be filled rapidly through the use of a more simplified, cheaper, less toxic regimen which is easier to take, complete and result in fewer side effects, defaults and higher treatment success rates.