Tuberculosis (TB)

Treatment of drug-resistant TB

A collage of images.

Resistance to TB drugs is a formidable obstacle to effective TB care and prevention globally. Multidrug-resistant TB (MDR-TB) is multifactorial and fuelled by improper treatment of patients, poor management of supply and quality of drugs, and airborne transmission of bacteria in public places. Case management becomes difficult and the challenge is compounded by catastrophic economic and social costs that patients incur while seeking help and on treatment.

Key topics

Active TB drug-safety monitoring and management (aDSM)

The term active TB drug-safety monitoring and management (abbreviated as aDSM) describes a new TB programme component to provide for the active and systematic clinical and laboratory assessment of patients on treatment for XDR-TB, or with new TB drugs or novel MDR-TB regimens to detect, manage and report suspected or confirmed drug toxicities.

WHO consolidated guidelines on drug-resistant tuberculosis treatment

Tuberculosis (TB) strains with drug resistance (DR-TB) are more difficult to treat than drug-susceptible ones, and threaten global progress towards the targets set by the End TB Strategy of the World Health Organization (WHO). There is thus a critical need for evidence-based policy recommendations on the treatment and care of patients with DR-TB, based on the most recent and comprehensive evidence available. In this regard, the WHO consolidated guidelines on drug-resistant tuberculosis treatment fulfil the mandate of WHO to inform health professionals in Member States on how to improve treatment and care for patients with DR-TB.

Introduction and rational use of new drugs for drug-resistant TB

During the last few years, two new drugs have emerged from the research pipeline - bedaquiline and delamanid, these are indicated for the treatment of drug-resistant TB. WHO has produced interim guidance on the use of these two new drugs. Further, to address challenges in preparing and enabling safe and effective uptake of new drugs or regimens under programmatic conditions in countries, WHO has issued a Policy Implementation Package.

News, events and announcements

  • 2018 update

    WHO treatment guidelines for multidrug- and rifampicin-resistant tuberculosis

    Tuberculosis (TB) strains with multidrug- and rifampicin-resistance (MDR/RR-TB) are more difficult to treat than drug-susceptible TB and threaten global progress towards the targets of the End TB Strategy set by the World Health Organization (WHO). The WHO treatment guidelines for multidrug- and rifampicin-resistant tuberculosis, 2018 update addresses the mandate of WHO to inform health professionals in Member States on how to improve MDR/RR-TB care.

    In 2018, WHO convened a Guideline Development Group (GDG) to update its policy recommendations on the treatment of MDR/RR-TB. The GDG was composed of a multidisciplinary group of external experts with experience in different aspects of the programmatic management of MDR/RR-TB as well as affected individuals. Ahead of their meeting in July 2018 in Switzerland, the GDG defined seven priority questions for the updated guidelines to cover. Topical areas of uncertainty on the composition and duration of longer MDR-TB regimens for adults and children, on when the standardized 9-12 month shorter MDR-TB regimen may be offered and the use of culture to monitor treatment response were included in the scope. Other aspects of MDR/RR-TB care for which no new evidence has emerged since the last time WHO policy was revised, such as the timing of antiretroviral therapy in MDR/RR-TB patients with human immunodeficiency virus (PLHIV), use of surgery and different models of care, were not reviewed and previous policies thus remain valid.

  • May 2016

    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.

  • April 2016

    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

  • November 2015

    Update to Guidance on ethics of tuberculosis prevention, care and control

    WHO is currently updating this guidance and convened a meeting of the Guideline Development Group in Geneva, Switzerland from 12 to 13 November 2015