The causative agent of MDR tuberculosis is resistant to at least isoniazid and rifampin, and in the case of XDR tuberculosis, also to fluoroquinolones and aminoglycoside. In 2012, 450000 people had MDR tuberculosis and 170000 people died of it. The majority of the cases were reported in South Africa, India, and Russia. In North West Russia nearly one third of the new tuberculosis cases are MDR. In Finland 2-5 new cases of MDR tuberculosis are notified annually, and this far only one case of XDR tuberculosis has been reported. Treatment of MDR tuberculosis lasts longer and costs more than treatment of drug-susceptible tuberculosis. Moreover, the second line drugs used are less effective and have more side effects than the first line drugs.