Anti‐tuberculosis Agents

Tuberculosis (TB) remains a leading infectious disease globally despite the use of chemotherapy and the BCG vaccine. The increasing emergence of multidrug-resistant/extensively drug-resistant TB (MDR/XDR-TB) poses a major threat to the effective control of TB. A brief overview of the current TB drugs and chemotherapy is provided. Mechanisms of resistance to the major frontline and second-line TB drugs in M. tuberculosis is discussed. The identification of drug-resistant mutations has allowed the development of commercial molecular tests for the rapid detection of drug-resistant TB to allow improved treatment. The problems of increasingly drug-resistant TB and of mycobacterial persistence call for development of new drugs that should be active against both drug-resistant bacteria and persisters, and that can shorten the therapy. Several classes of new TB drug candidates as well as repurposed existing drugs are currently being evaluated in clinical trials and offer significant promise for the improved treatment of both drug-resistant TB and drug-susceptible TB.