Clinical management of drug-resistant mycobacterium tuberculosis strains: Pathogen-targeted versus host-directed treatment approaches

Background: Despite exerted efforts to control and treat Mycobacterium tuberculosis (MTB) strains, Tuberculosis (TB) remains a public health menace. The emergence of complex drug-resistant profiles, such as multi-drug resistant and extensively drug-resistant MTB strains, emphasizes the need for early diagnosis of resistant cases, shorter treatment options, and effective medical interventions. Objective: Solutions for better clinical management of drug-resistant cases are either pathogen-centered (novel chemotherapy agents) or host-directed approaches (modulating host immune response to prevent MTB invasion and pathogenesis). Results: Despite the overall potentiality of several chemotherapy agents, it is feared that their effectiveness could be challenged by sequential pathogen adaptation tactics. On the contrary, host-directed therapy options might offer a long-term conceivable solution. Conclusion: This review discusses the main suggestions proposed so far to resolve the clinical challenges associated with drug resistance, in the context of TB. These suggestions include novel drug delivery approaches that could optimize treatment outcome and increase patients’ compliance to the treatment.