Recent advancements in drug development for pulmonary tuberculosis

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is a global health threat. Despite advances in diagnostics and treatment regimens, it infects millions annually. It remains a significant global health challenge, particularly due to the appearance of resistance towards anti-tuberculosis drugs (ATD), mainly multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains. Mtb poses resistance towards the currently used first- and second-line regimen. Recent advancements in drug development have introduced therapeutic options focussed on improving treatment outcomes for both drug-sensitive and drug-resistant TB. This includes the implementation of a shorter 6-month regimen, a combination of bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM), and all-oral treatment regimens (nine months treatment) for patients with MDR/Rifampicin TB-resistance. Another longer 18-20-month regimen is also accessible for patients with TB resistance, for whom all other regimens or treatments are not feasible due to various factors. Ongoing research into new drug molecules, adjunct therapies, and advancement in faster diagnosis aims to enhance the efficacy and tolerability of TB treatment while tackling challenges related to adherence and resistance. This review will discuss the limitations of current treatment regimens, and recent developments in the pharmacological landscape of TB management, highlighting innovative strategies and the necessity for continued efforts to combat the evolving threat of this headstrong pathogen. The findings underscore the importance of a patient-centered approach in TB treatment to achieve equitable and sustainable health outcomes globally.