Novel treatments in multidrug-resistant tuberculosis

The management of multidrug-resistant tuberculosis (TB) is associated with low treatment success, high mortality and failure rates. New drugs and novel short-therapeutic regimens have only recently helped overcome these obstacles. We carried out a narrative literature review aimed at summarizing the scientific evidence on the recent therapeutic advances in the field of drug-resistant TB. Experimental and observational studies on novel (i.e. bedaquiline, delamanid, pretomanid) drugs and novel regimens and the main pharmacological characteristics of the newest compounds are described. We also highlight the main scientific evidence on therapeutic strategies complementary to standard chemotherapy (i.e. new approaches to drug delivery, host-directed therapy, surgery, new collapse therapy, rehabilitation, and palliative care). •The clinical management of DR-TB cases is associated with lower treatment success, higher mortality and failure rates.•New and repurposed drug options have helped improve the therapeutic approach for drug-resistant tuberculosis.•Studies on safe, effective, all-oral, short-course therapeutic regimens have started to provide new anti-TB products.•New oral compounds in trial phase 2 have a potential future role in MDR-TB treatment.•Therapeutic strategies complementary to standard chemotherapy might be useful in difficult MDR-TB.