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This threat is further exacerbated in tuberculosis (TB), mainly due to a protracted treatment regimen involving a combination of drugs. A diversity of factors contributes to the emergence of drug resistance in TB, which is caused by the pathogen\n                    <jats:italic>Mycobacterium\u2009tuberculosis<\/jats:italic>\n                    (\n                    <jats:italic>Mtb<\/jats:italic>\n                    ). While the traditional genetic mutation\u2010driven drug resistance mechanisms operate in\n                    <jats:italic>Mtb<\/jats:italic>\n                    , there are also several additional unique features of drug resistance in this pathogen. Research in the past decade has enriched our understanding of such unconventional factors as efflux pumps, bacterial heterogeneity, metabolic states, and host microenvironment. Given that the discovery of new antibiotics is outpaced by the emergence of drug resistance patterns displayed by the pathogen, newer strategies for combating drug resistance are desperately needed. In the context of TB, such approaches include targeting the efflux capability of the pathogen, modulating the host environment to prevent bacterial drug tolerance, and activating the host anti\u2010mycobacterial pathways. In this review, we discuss the traditional mechanisms of drug resistance in\n                    <jats:italic>Mtb<\/jats:italic>\n                    , newer understandings and the shaping of a set of unconventional approaches to target both the emergence and treatment of drug resistance in TB.\n                  <\/jats:p>","DOI":"10.1111\/febs.17142","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T14:19:01Z","timestamp":1714227541000},"page":"4433-4452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Actionable mechanisms of drug tolerance and resistance in\n                    <i>Mycobacterium tuberculosis<\/i>"],"prefix":"10.1111","volume":"291","author":[{"given":"Dipanwita","family":"Datta","sequence":"first","affiliation":[{"name":"Cellular Immunology Group International Centre for Genetic Engineering and Biotechnology  New Delhi India"},{"name":"School of 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