• C Lange, W A Alghamdi, M H Al-Shaer, S Brighenti, A H Diacon, A R DiNardo, H P Grobbel, M I Gröschel, F von Groote-Bidlingmaier, M Hauptmann, J Heyckendorf, N Köhler, T A Kohl, M Merker, S Niemann, C A Peloquin, M Reimann, U E Schaible, D Schaub, V Schleusener, T Thye, and T Schön.
• Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.
• J. Intern. Med. 2018 May 28.

AbstractAccording to the World Health Organization (WHO), tuberculosis is the leading cause of death attributed to a single microbial pathogen worldwide. In addition to the large number of patients affected by tuberculosis, the emergence of Mycobacterium tuberculosis drug-resistance is complicating tuberculosis control in many high-burden countries. During the past 5 years, the global number of patients identified with multidrug-resistant tuberculosis (MDR-TB), defined as bacillary resistance at least against rifampicin and isoniazid, the two most active drugs in a treatment regimen, has increased by more than 20% annually. Today we experience a historical peak in the number of patients affected by MDR-TB. The management of MDR-TB is characterized by delayed diagnosis, uncertainty of the extent of bacillary drug-resistance, imprecise standardized drug regimens and dosages, very long duration of therapy and high frequency of adverse events which all translate into a poor prognosis for many of the affected patients. Major scientific and technological advances in recent years provide new perspectives through treatment regimens tailor-made to individual needs. Where available, such personalized treatment has major implications on the treatment outcomes of patients with MDR-TB. The challenge now is to bring these adances to those patients that need them most.© 2018 The Association for the Publication of the Journal of Internal Medicine.

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