Development of Tuberculosis Treatment Regimens

Treatment of tuberculosis (TB) includes various therapeutic regimens with a combination of at least four drugs. Adherence to the treatment regimen is crucial for efficacy outcomes based on the achievement of appropriate drug levels. Drug-resistant () strains are mainly favored by inadequate TB management. Inappropriate treatment of tuberculosis can contribute to the maintenance and spread of drug-resistant strains of Mycobacterium tuberculosis (MTB) in the community. Treatment of drug-resistant tuberculosis (DR–TB) is challenging because it requires the use of second-line anti-TB drugs, which are less effective and more toxic. The treatment of TB is aimed at curing patients, preventing relapse, TB transmission, drug resistance, and eradicating TB infection. Treatment efficacy directly depends on the choice of treatment regimen, its duration, drug metabolism, interactions, the development of side effects and their management, and associated diseases. The drugs should be administered in combination with at least four medicines, and their choice should be based on drug sensitivity testing (DST). In this chapter, the standardized regimens for the treatment of patients suffering from drug-susceptible TB (DS–TB) and DR–TB are described. For effective tuberculosis control, the appropriate application of old regimens, as well as the development and implementation of novel medicines and new treatment regimens in clinical practice, are needed.