Current Status of Multi Drug Resistance- Tuberculosis: A Major Public-Health Threat

Background: Rifampicin is the most effective first-line antibiotic for tuberculosis (TB). However, drug resistance, particularly multidrug-resistant TB (MDR-TB), poses a significant global health challenge. According to the World Health Organization (WHO), approximately 500,000 new TB cases in 2019 were resistant to treatment, with 78% showing multidrug resistance. India alone accounted for 27% of all MDR or rifampicin-resistant (RR) TB cases reported in 2020. MDR-TB, defined by resistance to at least isoniazid and rifampicin, is primarily driven by poor adherence to treatment, inappropriate antibiotic use, and transmission in crowded settings. Purpose: This review highlights the increasing threat of MDR-TB and underscores the need for alternative therapeutic strategies, improved diagnostic tools, and updated treatment guidelines to combat drug-resistant TB effectively. Methods: A literature-based analysis was conducted, focusing on recent WHO reports, updated guidelines, and emerging approaches in MDR-TB diagnosis and management, including molecular diagnostics, novel oral drugs, and adjunctive therapies such as nutritional and traditional support systems. Results: Recent WHO guidelines emphasize early detection using advanced molecular techniques and the use of repurposed oral anti-TB medications. These strategies show promise in enhancing disease control and patient outcomes. However, the implementation of new regimens requires further clinical evaluation. Integration of supportive care approaches such as nutrition and traditional therapies may contribute to a more holistic management of MDR-TB. Conclusion: The growing prevalence of MDR-TB and XDR-TB calls for urgent action in diagnosis, treatment, and patient support. While revised WHO strategies offer a promising framework, continued research and clinical trials are vital to optimize therapies and address global TB drug resistance effectively.