When dealing with multidrug‑resistant TB, a form of tuberculosis that stays resistant to at least isoniazid and rifampicin. Also known as MDR‑TB, it challenges health systems worldwide. The culprit is Mycobacterium tuberculosis, the bacterium that causes TB, which can acquire mutations that block the action of first‑line drugs. This resistance means MDR‑TB encompasses the loss of two cornerstone medicines, creating a need for more complex regimens. The disease requires a deeper understanding of bacterial genetics, and it drives public‑health policies to focus on early detection and strict adherence to therapy.
Because first‑line drugs fail, clinicians turn to second‑line anti‑TB drugs, medicines like fluoroquinolones, injectable aminoglycosides, and newer agents such as bedaquiline. These drugs are more expensive, have a higher side‑effect profile, and often require a longer treatment course. Yet, they enable a cure in many MDR‑TB cases, especially when combined in a well‑designed regimen. The World Health Organization (WHO) recommends specific combinations based on drug‑susceptibility patterns, and it updates these guidelines as new evidence emerges. Understanding the pharmacology of these agents is essential, because improper use can push patients toward extensively drug‑resistant TB (XDR‑TB), a situation that limits therapeutic options even further.
Choosing the right drugs starts with drug susceptibility testing, laboratory analysis that shows which antibiotics the TB strain can still be killed by. This testing guides the selection of an effective regimen and helps avoid unnecessary toxicity. Rapid molecular tests now provide results within days, allowing clinicians to act quickly. When testing reveals resistance beyond the standard second‑line agents, specialists may consider newer drugs like delamanid or repurposed antibiotics, always balancing efficacy with safety.
The collection below pulls together practical guides, drug comparisons, and safety tips that address the real‑world challenges of MDR‑TB. Whether you’re looking for the latest data on treatment options, want to understand how resistance develops, or need advice on navigating the WHO guidelines, the articles ahead give you actionable information you can trust. Dive in to see how experts break down complex regimens, compare drug profiles, and offer clear steps for managing this demanding condition.
A clear comparison of ethionamide (Trecator SC) with other TB drugs, covering mechanisms, side effects, costs, and when to choose each option.