Tuberculosis: Management of Drug-Resistant TB.

Introduction

Drug-resistant TB (DR-TB) is a topic many clinicians tend to avoid, as these patients are often referred to specialised clinics. However, treatment has changed from long injectable regimens to shorter all-oral regimens, which should improve adherence. The treatment success rate for RR-TB was only 58%, which highlights why early recognition, correct regimen selection, adherence support, and structured follow-up remain important even when specialised services are involved. South Africa has the ninth-highest rate of rifampicin resistance (RR) in the world, with 14 000 cases reported in 2017.
This article first clarifies the major categories of drug resistance, then outlines the practical steps for confirming RR-TB, selecting the appropriate regimen, monitoring treatment, managing adverse events, and following close contacts.