Journal of Biosciences

, Volume 33, Issue 4, pp 605–616 | Cite as

Multidrug resistant to extensively drug resistant tuberculosis: What is next?

  • Amita JainEmail author
  • Pratima Dixit


Drug resistant tuberculosis is a man made problem. While tuberculosis is hundred percent curable, multidrug resistant tuberculosis (MDR-TB) is difficult to treat. Inadequate and incomplete treatment and poor treatment adherence has led to a newer form of drug resistance known as extensively drug resistant tuberculosis (XDR-TB). XDR-TB is defined as tuberculosis caused by Mycobacterium tuberculosis strain, which is resistant to at least rifampicin and isoniazid among the first line anti tubercular drugs (MDR-TB) in addition to resistance to any fluroquinolones and at least one of three injectable second line anti tubercular drugs i.e. amikacin, kanamycin and/or capreomycin. Mismanagement of tuberculosis paves the way to drug resistant tuberculosis. Emergence of XDR-TB is reported world wide. Reported prevalence rates of XDR-TB of total MDR cases are; 6.6% overall worldwide, 6.5% in industrialized countries, 13.6% in Russia and Eastern Europe, 1.5% in Asia, 0.6% in Africa and Middle East and 15.4% in Republic of Korea. Better management and control of tuberculosis specially drug resistant TB by experienced and qualified doctors, access to standard microbiology laboratory, co-morbitidy of HIV and tuberculosis, new anti-TB drug regimens, better diagnostic tests, international standards for second line drugs (SLD)-susceptibility testing, invention of newer antitubercular molecules and vaccines and knowing the real magnitude of XDR-TB are some of the important issues to be addressed for effective prevention and management of XDR-TB.


Drug resistant tuberculosis extensively drug resistant tuberculosis (XDR-TB) multidrug resistant tuberculosis (MDR-TB) 

Abbreviations used


direct observation therapy strategy


isonicotinic acid hydrazide


multi drug resistant tuberculosis


second line anti tubercular drug


supranational reference laboratories


extremely drug resistant tuberculosis


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Copyright information

© Indian Academy of Sciences 2008

Authors and Affiliations

  1. 1.Post Graduate Department of MicrobiologyCSM Medical UniversityLucknowIndia

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