Tuberculosis (TB)

Drug-resistant tuberculosis

A collage of images.

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.

Global situation

Globally in 2014, there were an estimated 3.3% of new cases and 20% of previously treated cases with MDR-TB. Drug resistance surveillance data show that an estimated 480 000 people developed MDR-TB in 2014 and 190 000 people died. 300 000 cases of MDR-TB estimated among TB patients reported by national TB programmes in 2014. Extensively drug-resistant TB (XDR-TB) has been reported by 105 countries in 2014. On average, an estimated 9.7% of people with MDR-TB have XDR-TB.

Extensively drug-resistant tuberculosis (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).

fact buffet


480 000cases of MDR-TB estimated among TB patients

Global situation


123 000patients with MDR-TB detected and reported



111 000 patients were started on second-line treatment for MDR-TB


Key topics

Treatment of drug-resistant tuberculosis

Resistance to tuberculosis (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.

Multidrug-resistant tuberculosis surveillance

Surveillance of drug resistance in TB over the past two decades has informed and guided the response to the multidrug-resistant TB (MDR-TB) epidemic. The Global Project on Anti-TB Drug Resistance Surveillance is the oldest and largest project on surveillance of anti-microbial resistance in the world, reaching a milestone of 20 years of operations in 2014. Data on resistance to TB drugs are available for 144 countries, accounting for 95% of the world’s population and TB cases.

Guidance for implementation of PPM for management of drug-resistant TB

In most resource-poor countries with a high TB-burden, patients with symptoms suggestive of tuberculosis (TB) seek care from a wide array of health-care providers. Evidence suggests that failure to involve all care providers used by TB suspects and patients hampers case detection, delays diagnosis, leads to inappropriate and incomplete treatment, contributes to increasing drug resistance and places an unnecessary financial burden on patients.

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