Tuberculosis (TB) is a global health challenge with millions of
new cases and deaths annually world-wide. According to the
2020 WHO report, about 6 million new and relapsed cases
were diagnosed with about 160,000 cases laboratory-
confirmed cases with multidrug-resistant tuberculosis (MDR-
TB)/relapsing TB (/RR-TB).1 As for Egypt in 2020, about 7000
new and relapsed cases were diagnosed with 85% of the
bacteriologically confirmed new pulmonary TB cases tested
for rifampicin resistance were resistant.2
Rifampicin is an efficient drug for treatment of tuberculosis.
It has been prescribed as the first-line treatment in drug-
susceptible TB patients as well as in isoniazid resistant TB
patients. 3 It acts on the RNA polymerase and the rpoB gene is
the encoding gene.4 About 25 out of 34 mutations in that gene
have been found linked to the rifampicin resistan-
ce.5 Multidrug-resistant tuberculosis is defined as resistance to
rifampicin and isoniazid with many contributing reasons.