Multidrug-resistant tuberculosis without extensive drug resistance

• 2012Bedaquiline approved (FDA)
• 2014Delamanid approved (FDA)
• 2019Pretomanid approved (FDA)

Trials started per year, stacked by phase (darker = later phase). Source: ClinicalTrials.gov via Clin2, which tracks studies recruiting in recent years — early years undercount.

Multidrug-resistant tuberculosis without extensive resistance is curable in most patients. Modern all-oral regimens, built on drugs like bedaquiline, have transformed outcomes. Deaths have been falling in many settings where these treatments are available, though the global picture remains uneven. The 2012 approval of bedaquiline was a pivotal milestone, enabling shorter, safer therapy. Access gaps and specific resistance patterns still pose hurdles, but the medical capability itself now warrants this hopeful outlook.

How quickly do the new regimens work?

Treatment can often be completed in six months rather than the older 18-24 month regimens, with high success rates in clinical trials and programmatic settings.

Can MDR-TB be cured without extensive resistance?

Yes, modern all-oral regimens achieve bacterial conversion and high cure rates in most patients, although access to these treatments varies widely.

What does the research pipeline look like?

Over 20 trials have started in the last five years, including seven phase-3 studies, and more than 20 are currently active.

Is there a vaccine for adults?

No reliable vaccine for adults exists, so prevention is not the basis for the current cure-in-most assessment.

Why do some people still die if it's curable?

Access to effective treatment remains unequal, and certain resistance patterns or delayed diagnosis can reduce chances. These are equity issues as much as medical ones.