title: Drug-resistant tuberculosis.
abstract: OBJECTIVE
  This review discusses the recent evidence on epidemiology, diagnosis, and treatment of drug-resistant and multidrug-resistant (MDR) tuberculosis (TB), an area where solutions for better diagnosis and treatment continually develop.
  
  
  RESULTS
  The prevalence of drug resistance has been constantly rising during the recent years. It has peaked in eastern European countries such as Belarus, where a record of 35.5% MDR-TB amongst new cases have been reported from Minsk. New diagnostic tools are becoming available. Xpert MTB/RIF is by far the most promising of these new techniques. Clinical management of drug-resistant TB is still cumbersome. However, after over 40 years of neglect, new drugs are becoming readily available: delamanid, bedaquiline, and PA-824 combined into innovative regimens raise hopes for substantially higher success rates.
  
  
  CONCLUSIONS
  The innovative diagnostic tools recently validated are changing the traditional paradigms of TB diagnosis, for too long based on sputum smear, culture, and drug susceptibility testing. New anti-TB compounds, which can be combined with several 'old' drugs with new indications, are gradually modifying the chances of cure for MDR-TB cases. Although initial evidence appears promising, the market use of new drugs must be accompanied by a serious public health approach aimed at preventing the development of further drug resistance.
authors: Department of Infectious Diseases, Galliera Hospital, Genova, Italy. giovannibattista.migliori@fsm.it
authors: Emanuele
authors: E
authors: Pontali
authors: Alberto
authors: A
authors: Matteelli
authors: Giovanni B
authors: GB
authors: Migliori
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000032:analysis; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004359:Drug Therapy, Combination / Q000379:methods; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D015995:Prevalence; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins