SIGNIFICANT PROGRESS IN THE TREATMENT OF EXTRAPULMONARY TUBERCULOSIS: A COMPREHENSIVE REVIEW

Extrapulmonary tuberculosis (EPTB) accounts for a significant proportion of TB infections worldwide; however, its diverse clinical manifestations and tissue-specific involvement make diagnosis and treatment challenging. Recent years have seen substantial improvements in both the diagnosis and treatment of EPTB. Bedaquiline, delamanid, and pretomanid have revolutionized the treatment of multidrug-resistant and extensively drug-resistant tuberculosis. These drugs, often used in combination, enhance outcomes for both pulmonary and extrapulmonary diseases. Corticosteroids, immunomodulators like interferon-gamma, and vitamin D supplements effectively reduce inflammation and boost the immune response in severe cases of tuberculosis meningitis or pericarditis. Advanced drug delivery technologies, such as nanoparticles and liposomes, can improve drug bioavailability and target affected areas while minimizing overall toxicity. In resource-limited settings, the Directly Observed Treatment, Short-course (DOTS) strategy helps improve treatment adherence and outcomes. Future goals include personalizing drug regimens based on genetic and resistance profiles and developing shorter, less toxic treatment protocols. Expanding molecular diagnostic tools and laboratory capacity will enhance early detection and treatment. These advancements in EPTB management are expected to improve patient outcomes globally.