Anti-tuberculosis (TB) drug resistance is a major public health problem that threatens progress made in TB care and control worldwide. Drug resistance arises due to improper use of antibiotics in chemotherapy of drug-susceptible TB patients. This improper use is a result of a number of actions including, administration of improper treatment regimens and failure to ensure that patients complete the whole course of treatment. Essentially, drug resistance arises in areas with weak TB control programmes. A patient who develops active disease with a drug-resistant TB strain can transmit this form of TB to other individuals.
Globally in 2016, there were an estimated 4.1% of new cases and 19% of previously treated cases with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB). Drug surveillance data show that of the estimated 600 000 people developed MDR-TB in 2016, and 240 000 people died. In spite of increased testing, the number of MDR/RR-TB cases detected only reached 153 000. In 2016, 8 000 patients with extensively drug-resistant TB (XDR-TB) were reported worldwide. To date, 123 countries have reported at least one XDR-TB case. On average, an estimated 6.2% of people with MDR-TB have XDR-TB.
XDR-TB is a form of TB which is resistant to at least four of the core anti-TB drugs. It involves resistance to the two most powerful anti-TB drugs, isoniazid and rifampicin, also known as multidrug-resistance (MDR-TB), in addition to resistance to any of the fluoroquinolones (such as ofloxacin or moxifloxacin) and to at least one of three injectable second-line drugs (amikacin, capreomycin or kanamycin).
558 000new cases of MDR/RR-TB estimated in 2017Global situation
161 000patients with MDR/RR-TB detected and reported in 2017MDR-TB factsheet 2018
139 000patients were started on second-line treatment for MDR/RR-TB in 2017Global tuberculosis report 2017
News, events and meeting reports
12-14 November 2019
The scope of the upcoming update of the WHO drug-resistant TB guidelines will focus on the use of a modified all-oral shorter MDR/RR-TB regimen (i.e. less than 12-month duration); use of a novel regimen combining pretomanid, bedaquiline and linezolid; use of bedaquiline for more than 6 months and its concurrent use with delamanid. To ensure transparency and neutrality in this guideline development process, the names and brief biographies of experts being considered for participation in this guideline development group meeting are disclosed for public notice.
16-20 July 2018
WHO treatment guidelines for rifampicin- and multidrug-resistant tuberculosis, 2018 update - GDG meeting
WHO is convening a Guideline Development Group (GDG) meeting from 16 to 20 July 2018 to review the evidence for the treatment of MDR/RR-TB and make recommendations on the composition and duration of suitable treatment regimens. Systematic reviews and other newly emerging evidence will be used as per the WHO requirements for the development of the new policy.
WHO will convene a Guideline Development Group in July 2018 in order to assess the latest evidence and inform recommendations on the composition and duration of multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) regimens. To aid this process, individual patient data (IPD) from clinical trials, as well as observational studies, will be analysed, preferably using anonymised individual patient data.
28-29 June 2016
Guideline Development Group (GDG) Meeting: Revision of the interim policy on bedaquiline for MDR-TB treatment and special session on delamanid use in children
A Guidelines Development Group composed of tuberculosis experts was convened by WHO’s Global TB Programme to review data from recent studies of patients with drug-resistant TB, treated with bedaquiline and delamanid. The group met in Geneva on 28 and 29 June 2016 to review new data related to pharmacokinetics and pharmoacodynamics, effectiveness and safety, and to consider any relevant revisions to WHO interim policies (released in 2013 and 2014). The recommendations of the expert group on the use of delamanid in children (> 6) and for adolescents will inform upcoming WHO guidance revision. Further data on the use of bedaquiline are being collected and the evidence review is expected to be finalized in the second half of the year.
Rapid diagnostic test and shorter, cheaper treatment signal new hope for multidrug-resistant tuberculosis patients
New WHO recommendations aim to speed up detection and improve treatment outcomes for multidrug resistant tuberculosis (MDR-TB) through use of a novel rapid diagnostic test and a shorter, cheaper treatment regimen.
Updates on situation of drug-resistant TB in Papua New Guinea, with special emphasis on Daru Island
This document provides an update on the progress made since May 2015 and WHO's position to further support the country's efforts
- WHO best-practice statement on the off-label use of bedaquiline and delamanid for the treatment of multidrug-resistant tuberculosis
- WHO treatment guidelines for drug-resistant tuberculosis
- Public notice: Guideline Development Group (GDG) Meetings
- Global tuberculosis report
- Companion handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis
- Guidelines for surveillance of drug resistance in tuberculosis - 5th edition