Combating Drug-Resistant Tuberculosis: Advancements in Diagnostics and Therapeutics.

The increasing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR)Mycobacterium tuberculosis has emerged as a major global health concern. Advanced molecular diagnostics, including rapid assays, have improved resistance detection; however, resource-limited settings remain underserved. Nanotechnology-based drug delivery systems, including polymeric carriers, solid lipid nanoparticles, and silver nanoparticles, can provide targeted delivery, prolonged release, and improved bioavailability. Drug repurposing strategies using existing drugs like linezolid, celecoxib, and nitazoxanide also show a promising option in combating drug-resistant TB while reducing treatment duration. Host-directed therapies (HDTs) and natural products offer complementary strategies by enhancing host immune responses and providing multitarget antimycobacterial effects. This review emphasizes the drug resistance mechanisms and advancements in novel theranostics. Despite significant progress, challenges related to cost-effective scalability, accessibility of advanced diagnostics, and optimization of therapeutic systems continue to limit clinical translation. Future research must prioritize multidisciplinary collaborations to accelerate drug development, enhance diagnostic capabilities, and expand nanotechnology-based solutions to address the TB epidemic effectively.