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The same mistakes that were done in the 90s — giving the same regimen to a population where some of the bacteria are resistant to one or more of the drugs — are now repeated in some places despite the availability of tools for adequate drug susceptibility testing." Eastern Europe's Warning A nationwide study from Moldova — a country with one of the highest MDR/RR-TB rates globally — provides evidence of high levels of resistance among patients with treatment failure. Such a scenario could bring us back to the period when treatment success rates for MDR-TB were as low as around 40%, effectively erasing much of the progress made over the past decade," lead author and Associate Professor Dumitru Chesov, MD, PhD, from the Department of Pneumology & Allergology at the Nicolae Testemițanu State University of Medicine and Pharmacy in Chisinau, Moldova, told Medscape News Europe. The only reliable method for identifying resistance to these drugs at present is targeted next-generation sequencing, which remains not available in routine practice in most of the high-burden DR-TB countries." "Expanding access to such technologies is essential to improve early detection and treatment outcomes." He stressed that doctors across Europe must be aware that "migration, cross-border healthcare access, and delayed diagnosis can facilitate the regional spread of resistant strains." "Clinicians should maintain a high index of suspicion for resistance, especially in patients with prior TB treatment, poor clinical response, or links to high-burden regions," he added. The entire management of the patient should be perfect, which is something we can only dream about right now." She said Eastern European countries were of most concern given their high number of MDR-TB cases but added that their systems to test, diagnose, and treat with newer drugs are better than those in other parts of the world — including some countries in Western Europe."