What is MDR TB? Discuss its complications and treatment methods. (Multidrug-resistant tuberculosis)

Mofizur Rahman

What is MDR TB? Discuss its complications and treatment methods.

What is MDR TB? Discuss its complications and treatment methods.



Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications, isoniazid and rifampicin.

Risk patient:

Those patients may develop MDR-TB who-
Do not take their TB drugs regularly;
Do not take all of their TB drugs;
Develop TB disease again, after being treated for TB disease in the past;
Come from areas of the world where drug-resistant TB is common;
Have spent time with someone known to have drug-resistant TB disease.


High cure rates of MDR-TB were achieved only with the introduction of the fluoroquinolones.

So following drugs being used for Bangladesh regimen: gatifloxacin, clofazimine, ethambutol, and pyrazinamide. This was supplemented by high dose isoniazid, kanamycin and prothionamide during the first four months.

National Guideline and Operational Manual for Tuberculosis অনুযায়ী প্রকারভেদসমূহ লিখুন। Classification of Anti-Tubercular Drugs এর শ্রেণিবিভাগ উল্লেখ করুন।

According to National Guideline and operational Manual for Tuberculosis, 2021-
Classifications of TB:

A.  According to anatomical site of the disease: 
  1. Pulmonary TB
  2. Extra-pulmonary TB

B.  According to history of previous TB treatment:
  1. New TB
  2. Previously Treated TB:


  • Treatment after failure
  • Treatment after loss to follow up
  • Other previously treated

C.  According to Drug Resistance:
  1. Mono-resistance
  2. Poly-resistance
  3. Multi-Drug Resistance TB (MDR-TB)
  4. Extensively Drug Resistance TB (XDR-TB)bar od
  5. Rifampicin Resistance (RR)

D. According to HIV Status:
  1. HIV-positive TB patient
  2. HIV-negative TB patient
  3. HIV-status unknown TB patient

E.  According to other considerations:
  1. Transfer in TB
  2. Transfer out TB
  3. Other: Patient who cannot be included in any one of the above categories

Anti-tubercular Drugs Classification:

Description Drug

First line Anti-TB drugs

  1. Oral drugs
  2. Isoniazid
  3. Rifampicin
  4. Ethambutol
  5. Pyrazinamide
  6. Rifabutin
  7. Rifapentine

Second line Anti-TB drugs

Group A
(Include all three medicines)
  1. Levofloxacin/Moxifloxacin
  2. Bedaquiline
  3. Linezolid
Group B
(Add one or both medicines)
  1. Clofazimine
  2. Cycloserine/Terizidone

Group C
(Add to complete the regimen and when medicines from group A and B cannot be used)
  1. Ethambutol
  2. Delamanid
  3. Pyrazinamide
  4. Imipenem-cilastatin/Meropenem
  5. Amikacin
  6. Ethionamide or Protionamide
  7. amino salicylic acid
এমডিআর টিবি কি? এর জটিলতা এবং চিকিৎসা পদ্ধতি নিয়ে আলোচনা করুন।

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