Diagnosis and Treatment of Multidrug/Rifampicin-Resistant Tuberculosis

To rapidly diagnose multidrug/rifampicin-resistant tuberculosis (MDR/RR-TB), all individuals suspected of having tuberculosis should undergo the Xpert MTB/RIF assay or an equivalent test capable of simultaneously detecting Mycobacterium tuberculosis and rifampicin resistance. Upon confirmation of rifampicin resistance, treatment for MDR/RR-TB should be initiated promptly, with preference given to shorter treatment regimens, such as BPaLM, MDR-END, or BPaL. Medications included in each regimen should be administered at the recommended dosages and for the entire treatment duration. Careful monitoring and management of potential adverse effects, including bone marrow suppression, peripheral neuropathy, optic neuritis, and QT interval prolongation are essential. The advent of shorter regimens has made MDR/RR-TB treatment more convenient and accessible for many patients. However, to further improve treatment outcomes and reduce the prevalence of MDR/RR-TB in Korea, comprehensive patient-centered management should be integrated across all stages of diagnosis and treatment.