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Treatment of drug-resistant pulmonary tuberculosis in adults

Neil W Schluger, MD
Scott K Heysell, MD, MPH
Gerald Friedland, MD
Section Editor
C Fordham von Reyn, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide. Diagnosis, treatment, and prevention of TB has become more complex because of resistance to commonly used antituberculous drugs. (See "Epidemiology and molecular mechanisms of drug-resistant tuberculosis".)

Management of drug-resistant TB can be difficult and may necessitate use of second-line drugs and/or surgical resection. Management of such patients should be undertaken by individuals with expertise in this area or in very close consultation with such individuals, in the context of a supportive public health infrastructure [1-3]. Good patient outcomes depend upon rapid and accurate diagnosis together with administration of proper therapy with close monitoring to assure adherence to the treatment regimen and patient safety.

Issues related to treatment of drug-resistant TB are reviewed here. Issues related to treatment of drug-susceptible TB are discussed separately, as are issues related to interactions between second-line TB drugs and antiretroviral therapy in HIV-infected individuals. (See "Treatment of drug-susceptible pulmonary tuberculosis in HIV-uninfected adults" and "Treatment of pulmonary tuberculosis in HIV-infected adults: Initiation of therapy".)


Definitions to describe the different types of drug-resistant tuberculosis include the following:

The term "drug-resistant tuberculosis" refers to TB caused by an isolate of Mycobacterium tuberculosis that is resistant to one or more antituberculous drugs.

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Literature review current through: Dec 2017. | This topic last updated: Nov 30, 2017.
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