Can multidrug-resistant and extensively drug-resistant tuberculosis be treated more successfully?

Objective 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 WHO data, combined with an analysis of historical medical records, to suggest a new treatment. Methods Data from the WHO for all countries of the World (N=215) on the epidemiology of all TB cases, HIV-related TB, multi-drug-resistant TB (MDR) and extremely-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 success rates of drug-resistant cases if sanatoria were added to treatment regimes. Results After 2012, the number of MDR and XDR cases increased faster than the total number of TB cases, and so did their proportions among the total. Success rates of MDR (~70%) and XDR (around 60%) treatments would raise 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.