The World Health Organization (WHO) released updated guidelines for the programmatic management of drug-resistant tuberculosis (MDR-TB) in 2011. These guidelines aim to improve the diagnosis, treatment, and care of MDR-TB patients globally. The guidelines were developed through a systematic review of evidence on key questions related to case-finding, treatment regimens, monitoring, and models of care. A multidisciplinary expert panel used the GRADE approach to assess the quality of evidence and formulate recommendations. Key recommendations include the use of rapid drug susceptibility testing (DST) for isoniazid and rifampicin, which is more effective than conventional testing. Treatment regimens for MDR-TB should include pyrazinamide, a fluoroquinolone, a second-line injectable drug, ethionamide (or prothionamide), and either cycloserine or p-aminosalicylic acid. The guidelines recommend that treatment last at least 20 months and that patients with HIV on second-line regimens receive antiretroviral therapy (ART) as soon as possible. Ambulatory care models are preferred over hospital-based models. The guidelines emphasize the importance of early diagnosis and treatment to prevent transmission and reduce mortality. They also highlight the need for cost-effective strategies, such as rapid DST and monthly sputum smear and culture monitoring. The use of fluoroquinolones is strongly recommended, while later-generation fluoroquinolones are preferred. Ethionamide is also strongly recommended for MDR-TB treatment. The guidelines note that the quality of evidence is generally low, and further research is needed to improve the evidence base, particularly for pediatric MDR-TB, treatment of isoniazid-resistant TB, and chemoprophylaxis for contacts. The guidelines also emphasize the importance of integrating HIV and TB care, ensuring adherence to treatment, and minimizing the risk of transmission through proper infection control measures. The WHO and its partners aim to promote the implementation of these guidelines globally, with support from scientific organizations and research groups. The guidelines are a critical resource for healthcare providers and policymakers to improve the management of MDR-TB and reduce its global burden.The World Health Organization (WHO) released updated guidelines for the programmatic management of drug-resistant tuberculosis (MDR-TB) in 2011. These guidelines aim to improve the diagnosis, treatment, and care of MDR-TB patients globally. The guidelines were developed through a systematic review of evidence on key questions related to case-finding, treatment regimens, monitoring, and models of care. A multidisciplinary expert panel used the GRADE approach to assess the quality of evidence and formulate recommendations. Key recommendations include the use of rapid drug susceptibility testing (DST) for isoniazid and rifampicin, which is more effective than conventional testing. Treatment regimens for MDR-TB should include pyrazinamide, a fluoroquinolone, a second-line injectable drug, ethionamide (or prothionamide), and either cycloserine or p-aminosalicylic acid. The guidelines recommend that treatment last at least 20 months and that patients with HIV on second-line regimens receive antiretroviral therapy (ART) as soon as possible. Ambulatory care models are preferred over hospital-based models. The guidelines emphasize the importance of early diagnosis and treatment to prevent transmission and reduce mortality. They also highlight the need for cost-effective strategies, such as rapid DST and monthly sputum smear and culture monitoring. The use of fluoroquinolones is strongly recommended, while later-generation fluoroquinolones are preferred. Ethionamide is also strongly recommended for MDR-TB treatment. The guidelines note that the quality of evidence is generally low, and further research is needed to improve the evidence base, particularly for pediatric MDR-TB, treatment of isoniazid-resistant TB, and chemoprophylaxis for contacts. The guidelines also emphasize the importance of integrating HIV and TB care, ensuring adherence to treatment, and minimizing the risk of transmission through proper infection control measures. The WHO and its partners aim to promote the implementation of these guidelines globally, with support from scientific organizations and research groups. The guidelines are a critical resource for healthcare providers and policymakers to improve the management of MDR-TB and reduce its global burden.