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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.

Original publication




Journal article


European respiratory review : an official journal of the European Respiratory Society

Publication Date





Dept of Infectious Diseases, Galliera Hospital, Genova, Italy.


and the writing group members of the Global TB Network Clinical Trials Committee, Humans, Tuberculosis, Multidrug-Resistant, Antitubercular Agents, Treatment Outcome, Drug Therapy, Combination, Drug Administration Schedule, Drug Resistance, Multiple, Bacterial, Forecasting, History, 20th Century, History, 21st Century, Diffusion of Innovation, Extensively Drug-Resistant Tuberculosis