Summary The objective: improving the efficacy of treating tuberculosis with extensive drug resistance of M. tuberculosis. Materials and methods: A clinical example of effective treatment of a patient with respiratory tuberculosis caused by multidrug-resistant mycobacteria (MDR MBT) is presented. Results. This is a clinical case with successfully treatment of patient with the use of new anti-TB drugs, in which serious adverse reactions developed, but as a result of timely correction were eliminated. Conclusion. The appointment of anti-Tb drugs such as Тhioureidoiminomethylpyridinium perchlorate, Вedaquiline, Meropenem and Linezolid and despite the development of adverse drug events associated with their using, were allowed to achieve successful results of therapy during short terms - the cessation of bacterial excretion and radiological positive dynamics in a patient with destructive pulmonary MDR tuberculosis.