Rosella Centis1, Lia D'Ambrosio2 and Giovanni Battista Migliori1 1Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate 21049, Italy 2Public Health Consulting Group, Lugano 6900, Switzerland Correspondence: giovannibattista.miglioriicsmaugeri.it

Tuberculosis is an airborne infectious disease treated with combination therapeutic regimens. Adherence to long-term antituberculosis therapy is crucial to maintain adequate blood drug level. The emergence and spread of drug-resistant Mycobacterium tuberculosis strains is mainly favored by the inadequate medical management of patients. The therapeutic approach for drug-resistant tuberculosis is cumbersome, because of the poor, expensive, less effective, and toxic alternatives to the first-line drugs. New antituberculosis regimens have been recently approved by the health authorities shortening the duration of treatment for both drug-susceptible and drug-resistant tuberculosis drugs, including new drugs such as bedaquiline, delamanid, and pretomanid. Unfortunately, they cannot represent the definitive solution to the clinical management of drug-resistant tuberculosis forms, particularly in intermediate economy settings where the prevalence of drug-resistance is high (China, India, and Former Soviet Union countries among others). Last but not least, new evidence on the burden of posttuberculosis lung disease calls for effective prevention, treatment, and rehabilitation of this form of disease. New research and development activities are urgently needed. Public health policies are required to preserve the new and old therapeutic options.