The treatment of resistant tuberculosis depends on the type of resistance. As the recommendations for the diagnosis and treatment of resistant tuberculosis are currently changing rapidly, treatment planning and support in or in consultation with an experienced tuberculosis center is recommended.

In the case of mono-resistant tuberculosis (resistance to a single drug), the therapy is adapted by replacing the resistant drug with another effective drug. Rifampicin resistance is assessed and treated in the same way as multidrug-resistant tuberculosis.

In the case of multidrug-resistant tuberculosis (MDR-TB), where the pathogen is resistant to at least isoniazid and rifampicin, a combination of other, less frequently used drugs is used.

There are shorter treatment regimens that contain fixed drug combinations and must be taken for 6 to 9 months. This is the BPaLM regimen, for example. As an alternative treatment, e.g. in the case of further resistance or intolerance, an individually composed therapy over 18 months is necessary.

In the case of extensively drug-resistant multidrug resistance (XDR-TB), where there is also resistance to these reserve drugs, treatment is even more complex and protracted. It can take up to two years and often requires the use of drugs with severe side effects. Close medical supervision is necessary throughout the entire treatment in order to monitor the success of the therapy and recognize side effects at an early stage. It is also important that patients adhere strictly to the therapy in order to prevent the development of further resistance.