A new free-cost e-service supporting clinicians to manage their difficult-to-treat tuberculosis cases: The European respiratory society-World Health Organization tuberculosis consilium

The pandemic of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR-TB), respectively, defined as resistance to isoniazid and rifampicin, and to at least one fluoroquinolone and one injecTable second-line anti-TB drug in addition to isoniazid and rifampicin, is attracting more and more interest1,2,3. Over 480,000 cases of MDR-TB (and 100,000 of rifampicin-resistant TB)1 are challenging physicians all over the world, as treating these cases is long, expensive and clinically complicated2,3,4,5,6,7,8,9,10. Furthermore, the results are still largely suboptimal with success rates in the order of 50 per cent in MDR-TB patients, which become as low as 20 per cent (with 15% failure/relapse and 35% death rates)2,3,10 in cases harbouring Mycobacterium tuberculosis strains with resistances beyond XDR2,3.