British Medical Journal
28 February 2015(vol 350, issue 7997)
http://www.bmj.com/content/350/7997

Clinical Review
Multidrug resistant tuberculosis
James Millard, clinical lecturer in global health1,
Cesar Ugarte-Gil, epidemiologist2,
David A J Moore, professor of infectious diseases & tropical medicine3
BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h882 (Published 26 February 2015) Cite this as: BMJ 2015;350:h882

The bottom line
– Multidrug resistant tuberculosis refers to tuberculosis with resistance to at least rifampicin and isoniazid
– Multidrug resistant tuberculosis is increasingly common; however, there is a large shortfall between the estimated total number of cases and the numbers diagnosed and treated
– Diagnosis is hampered by lack of access to quality assured diagnostics, although newer, rapid molecular and phenotypic methods may go some way to improving this situation
– Compared with drug susceptible tuberculosis, treatment for multidrug resistant tuberculosis requires the use of drug regimens that are prolonged (18-24 months), less efficacious, and noticeably more toxic; new drugs and regimens are becoming available for the first time in decades and ongoing trials should define how best they should be used
– Worldwide, treatment success is only around 50%; however, several settings, including some low income countries, have proved that higher success rates are achievable