Multi-drug Resistant Tuberculosis Management

Rifampicin-resistant Tuberculosis (RR-TB) and Multidrug resistant Tuberculosis (MDR-TB) are a current global health threat, and are characterised by high mortality, chronic sequelae, complexity and high cost. The drug resistant form of this infectious disease was globally responsible for 600,000 new cases in 2017, with 161,000 cases being notified and only 139,000 treated. It is evident that given its predilection to propagate and inadequate and unsatisfactory control of the infection, that more needs to be done in many countries worldwide.Over the last decade new rapid diagnostic methods like the GeneXpert, and availability of new MDR-TB drugs and the shorter treatment regimen have been recommended and disseminated to TB programmes worldwide, in the hope that these new tools and resources will make an impact on the pandemic. We are however cognisant that control and elimination can only occur if patients affected by the disease are diagnosed (rapidly) and swiftly started on effective treatment that they can tolerate and complete. The following chapter will describe the current best-practice management recommendations for RR/MDR-TB and summarise current best practice and guidelines.