Mechanisms of Antibiotic Resistance and Novel Therapeutic Approaches for Mycobacterium tuberculosis: A Narrative Review With a Focus on Tuberculosis Mutations in Iran.

Background and Aims: Tuberculosis, caused by Mycobacterium tuberculosis (M. tuberculosis), is a highly contagious disease and one of the leading causes of mortality globally. The emergence and dissemination of multidrug-resistant (MDR) strains of M. tuberculosis have become a major concern, especially in developing countries. Antibiotic resistance in bacteria constitutes a substantial threat to human health, both now and in the future. The current treatment regimens for tuberculosis are challenging and demanding. Consequently, understanding the antibiotic resistance mechanisms of M. tuberculosis is of paramount importance for global health. This review provides a comprehensive overview of the present state of M. tuberculosis antibiotic resistance by elucidating the underlying mechanisms and presenting up-to-date information and findings in the field. It also highlights deficiencies and challenges in existing studies, with particular emphasis on tuberculosis mutations in the Iranian studies. Furthermore, the study investigate into contemporary global treatment modalities and illuminates new therapeutic avenues for tuberculosis management. Method: This study conducts a review of the literature on M. tuberculosis and its antibiotic resistance, using databases such as Scopus, Embase, MEDLINE/PubMed, Web of Science, and Google Scholar. Results: The current status of antibiotic resistance in M. tuberculosis represents a serious threat to global health. MDR and extensively drug-resistant (XDR) strains of M. tuberculosis are becoming increasingly widespread. Conclusion: The increasing antibiotic resistance in M. tuberculosis constitutes a significant global health threat, with MDR and XDR strains becoming more prevalent. Effective responses require the development of novel therapeutic drugs, ensuring patients complete their full drug treatment courses, implementing innovative strategies to prevent resistance, and accelerating the creation of effective compounds. Large-scale studies on diverse populations are essential to develop comprehensive solutions and combat the spread of resistance in tuberculosis. Urgent and coordinated efforts are needed to enhance treatment efficacy and control the spread of drug-resistant TB.