Bhering M, et al. - Researchers analyzed data on 2,269 resistant multidrug TB (MDR-TB) cases reported in 2000–2016 in Rio de Janeiro State from the Tuberculosis Surveillance System in order to determine the factors correlated with the unfavorable treatment of MDR/extensively resistant TB (TB-XDR) patients in that State. Among MDR-TB and XDR-TB, unfavorable outcomes were reported in 41.9% and 81.5%, respectively. Unfavorable outcome and default were reported in correlation to having less than 8 years of schooling, and being an Afro-Brazilian, under 40 years old and drug user. Association of bilateral disease, HIV positive, and comorbidities with death was noted. A 4.7-fold higher odds of an unfavorable outcome was noted for XDR-TB cases, with 29.3% of such cases being not treated for multidrug resistance in the past. Primary transmission seems to have resulted in about 30% of XDR-TB cases. In this category, the high rates of failure and death indicate the limitation of treatment options. This highlights the urgent necessity for the incorporation of new drugs in the treatment.