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Clinical Review State of the Art Review

Current and future treatments for tuberculosis

BMJ 2020; 368 doi: (Published 02 March 2020) Cite this as: BMJ 2020;368:m216
  1. Anthony Lee, medical student1 2,
  2. Yingda Linda Xie, assistant professor2 3,
  3. Clifton E Barry, senior investigator2,
  4. Ray Y Chen, associate research clinical2
  1. 1Medical Research Scholars Program, National Institutes of Health, Bethesda, MD, USA
  2. 2Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Medicine, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
  3. 3Division of Infectious Diseases, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
  1. Correspondence to RY Chen ray.chen{at}


Guidelines on the treatment of tuberculosis (TB) have essentially remained the same for the past 35 years, but are now starting to change. Ongoing clinical trials will hopefully transform the landscape for treatment of drug sensitive TB, drug resistant TB, and latent TB infection. Multiple trials are evaluating novel agents, repurposed agents, adjunctive host directed therapies, and novel treatment strategies that will increase the probability of success of future clinical trials. Guidelines for HIV-TB co-infection treatment continue to be updated and drug resistance testing has been revolutionized in recent years with the shift from phenotypic to genotypic testing and the concomitant increased speed of results. These coming changes are long overdue and are sorely needed to address the vast disparities in global TB incidence rates. TB is currently the leading cause of death globally from a single infectious agent, but the work of many researchers and the contributions of many patients in clinical trials will reduce the substantial global morbidity and mortality of the disease.


  • Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors

  • Acknowledgment: This research was supported by the Intramural Research Program of the US National Institutes of Health, National Institute of Allergy and Infectious Diseases.

  • Contributorship: YLX, CEB, and RYC developed the idea for this review. AL, YLX, and RYC performed the literature search. AL, YLX, CEB, and RYC wrote the review. RYC is the guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The author declares the following other interests: none.

  • Further details of The BMJ policy on financial interests are here:

  • Provenance and peer review: commissioned; externally peer reviewed.

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