Rising to the challenge: new therapies for tuberculosis

The standard treatment for tuberculosis (TB) is lengthy, complex, and significantly toxic. Drug development for TB has stagnated for decades, but in recent years renewed commitment and coordinated research has generated a modest pipeline of new drugs that hold the potential to make treatment more effective, shorter, less complex, and less toxic in the near future. With a particular focus on bedaquiline (TMC207), the first anti-TB drug of a novel class to be approved by the US Food and Drug Administration (FDA) in 40 years, this review summarizes the recent evidence behind new developments in TB treatment. Novel drug classes, repurposed drugs, and host-directed therapies are reviewed. In parallel to these exciting developments in drug discovery, we propose that it is crucial to develop more rapid and comprehensive diagnostics that will allow the timely selection of the best regimen for individual patients.