Can Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis be Treated More Successfully?

BACKGROUND: Signs and symptoms of tuberculosis (TB) are a result of a disturbed balance between Mycobacterium tuberculosis and the patient's tolerance to its pathogenic properties. Pharmacological treatments elicit the evolution of drug resistance, and there is a need to consider alternative treatment methods. We performed a statistical analysis of World Health Organization (WHO) data, combined with an analysis of old medical records, aimed at suggesting a new treatment. METHODS: Data from the WHO for all countries worldwide (N = 215) on the epidemiology of all TB cases, human immunodeficiency virus (HIV)-related TB, multidrug-resistant TB (MDR) and extensively drug-resistant TB (XDR) in 2012-2022 contain prevalence, success rate of treatment, mortality and numbers of failed treatments and patients lost-to-follow-up. Data on success rates in old 'sanatoria treatment', widespread before the 1940s, were used to predict hypothetical success rates of drug-resistant cases if sanatoria treatment were added to treatment regimes. RESULTS: After 2012, the number of MDR and XDR cases increased faster than the total number of TB cases, as did their proportions among the total. Success rates of MDR (∼70%) and XDR (around 60%) treatments would hypothetically increase to around 90%, when supplemented by sanatoria treatment success. CONCLUSIONS: Adding treatments for increasing tolerance to TB infection to the current pharmacological treatments may improve outcomes.