Maladies mycobactériennes
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Anti-Tuberculous Drugs and Susceptibility Testing Methods: Current Knowledge and Future Challenges

Jobran Miree Alqahtani and Ahmed Morad Asaad

The emergence of multi-drug resistant tuberculosis (MDR-TB) outbreaks during 1990s and more recently the highly lethal strains of extensively drug-resistant TB (XDR-TB) is hampering efforts to control and manage tuberculosis (TB), and also threatening World Health Organization’s target of TB elimination by 2050. The TB community has promoted a full pipeline of candidate for the new TB drugs at all phases of development. The majority of candidates are in preclinical and early clinical development. The challenge of conducting these trials, especially that they will be conducted in resource-poor locations with limited infrastructure or trials experience will be considerable. New tuberculosis drug regimens are creating new priorities for drug susceptibility testing (DST) and surveillance. To minimize turnaround time, rapid and sensitive DST will need to be prioritized, but developers of these assays will need better data about the molecular mechanisms of drug resistance. Investment to develop costeffective and robust DST methods for peripheral laboratories or to create rapid, reliable sample transport systems to support centralized DST is questionable. Optimization of treatment regimens together with rapid diagnosis and DST for first- and second-line drugs as well as newer TB drugs, will greatly improve the prognosis and clinical outcome of TB patients.