Archives of Toxicology

, Volume 90, Issue 7, pp 1585–1604 | Cite as

Antibiotic resistance mechanisms in M. tuberculosis: an update

  • Liem NguyenEmail author
Review Article


Treatment of tuberculosis (TB) has been a therapeutic challenge because of not only the naturally high resistance level of Mycobacterium tuberculosis to antibiotics but also the newly acquired mutations that confer further resistance. Currently standardized regimens require patients to daily ingest up to four drugs under direct observation of a healthcare worker for a period of 6–9 months. Although they are quite effective in treating drug susceptible TB, these lengthy treatments often lead to patient non-adherence, which catalyzes for the emergence of M. tuberculosis strains that are increasingly resistant to the few available anti-TB drugs. The rapid evolution of M. tuberculosis, from mono-drug-resistant to multiple drug-resistant, extensively drug-resistant and most recently totally drug-resistant strains, is threatening to make TB once again an untreatable disease if new therapeutic options do not soon become available. Here, I discuss the molecular mechanisms by which M. tuberculosis confers its profound resistance to antibiotics. This knowledge may help in developing novel strategies for weakening drug resistance, thus enhancing the potency of available antibiotics against both drug susceptible and resistant M. tuberculosis strains.


Tuberculosis Drug resistance Antibiotic Mycobacterium Mechanism Bactericidal 



Work in the Nguyen laboratory is supported by NIH Grants R01AI087903 and R21AI119287.


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© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Molecular Biology and Microbiology, School of MedicineCase Western Reserve UniversityClevelandUSA

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