Treating Drug-Resistant Tuberculosis

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Topic Overview

People infected with tuberculosis (TB) bacteria that are antibiotic-resistant have what is called drug-resistant tuberculosis. There are different types of drug-resistant TB.

  • Mono-resistant TB happens when the bacteria don't respond to one first-line drug.
  • Multidrug-resistant TB happens when the bacteria don't respond to at least the two strongest TB drugs (isoniazid and rifampin).
  • Poly-resistant TB happens when the bacteria don't respond to more than one first line drug other than isoniazid and rifampin.
  • Extensively drug-resistant TB happens when the bacteria are resistant to isoniazid, rifampin, and several other medicines used to treat TB. This is rare.

People with drug-resistant tuberculosis need special treatment programs. Treatment usually involves several medicines.

  • The choice of medicines depends on the results of sensitivity testing .
  • It is very important to take every dose of medicine. So directly observed therapy (DOT) usually is done. During DOT, a health professional watches you take every dose of medicine.
  • Treatment is continued until TB bacteria can no longer be found in two sputum samples taken a month apart. This may take 18 months or longer in people with multidrug-resistant TB (MDR-TB).

Some TB bacteria have become resistant to all of the antibiotics that are commonly used to treat TB. This is sometimes called totally resistant tuberculosis (TDR-TB). footnote 1 A TB infection of this type is very difficult to treat.

Related Information



  1. Cegielski P, et al. (2012). Challenges and controversies in defining totally drug-resistant tuberculosis. Emerging Infectious Diseases [Internet], November. Available online:


ByHealthwise Staff

Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine

Adam Husney, MD - Family Medicine

Specialist Medical Reviewer R. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care Medicine, Medical Toxicology

W. David Colby IV, MSc, MD, FRCPC - Infectious Disease

Current as ofNovember 22, 2017