Abstract
Despite global efforts to control and eradicate tuberculosis (TB), it remains a significant source of morbidity and mortality worldwide. Drug-resistant TB (DRTB) is a significant public health threat with implications for global health security, economic burden, and access to quality care. To address this challenge, continued investment in research, surveillance, and innovative strategies is crucial. Collaboration among international organizations, governments, and health-care systems is crucial to tackle this global health concern effectively. Bedaquiline (BDQ), a diarylquinoline drug, is indicated for combination therapy in adult patients with pulmonary multidrug-resistant TB (MDRTB). The Food and Drug Administration (FDA) granted accelerated approval in December 2012, based on analysis of time to sputum culture conversion from two phase 2 trials. The World Health Organization (WHO) published interim policy guidance for BDQ in conjunction with WHO-recommended MDRTB treatments in June 2013. The European Medicines Agency authorized Delamanid as a first-in-class bicyclic nitroimidazole for treating MDRTB, which has been used in 89 and 54 nations due to its quick acquisition of resistance. To prevent resistance, combined therapy with additional anti-TB drugs is advised, along with proper use and drug resistance monitoring. Pretomanid received approval from the US FDA in August 2019 after a phase III trial yielded encouraging results. The bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM) regimen, a component of the BPaLM regimen, has been approved for treating adults with extensive pulmonary DRTB or treatment-intolerant or non-responsive MDRTB. This significant advancement in management offers improved clinical outcomes and quality of life for MDRTB patients. The inclusion in the WHO guidelines is encouraging for global combat against DRTB. Researchers have identified and investigated new drug targets within the TB pathogenesis, offering promising avenues for the development of innovative anti-TB drugs. Advances in pediatric TB treatment have made significant progress, focusing on improved diagnostic methods, effective drug treatments, and global initiatives. Nanotechnology has shown promising potential in various fields, including medicine and TB treatment.

Key words: Tuberculosis; Multidrug-resistant Tuberculosis; New Drugs; Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin Regimen