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Managing drug resistant tuberculosis

Antituberculosis drug resistance is increasing both in the United Kingdom and internationally.12 It has come to greater public attention with the emergence of extensively drug resistant tuberculosis (box 1) in South Africa, where an outbreak proved rapidly fatal among people with advanced HIV infection.3 In this article we review recent global and UK trends in drug resistant tuberculosis and summarise its diagnosis, treatment, and control. Few data are available from randomised controlled trials to guide treatment of drug resistant tuberculosis, and none for multidrug resistant tuberculosis; this review is based primarily on data from observational epidemiological studies and on national and international guidelines. How did we get to where we are? Writing in this journal.