Poor treatment of pleural effusion due to tuberculous pleurisy in the elderly can be seen in irregular drug taking, tuberculous pleurisy, pleural effusion with a long history of forming pleural adhesions and possible drug resistance. 1. Irregular drug taking: Tuberculous pleurisy needs to comply with early, regular, combined, full, appropriate amount of anti-tuberculosis treatment, if irregular drug taking, the blood concentration is lower than the therapeutic concentration will appear pleural effusion absorption is slow or even drug resistance, which leads to the effusion can not be controlled. 2. Long history of pleural adhesion: tuberculous pleurisy, pleural effusion is exudate, protein content is generally greater than 30g/L, if the history of disease is long, the anti-tuberculosis treatment is not timely, the pleural effusion drainage is not complete easy to appear pleural thickening, adhesion formation of encapsulated effusion, the absorption of pleural effusion is slower, the clinical effect of the treatment is poor, and need to carry out the pleura peeling and adhesion release surgical treatment. 3. Drug resistance: Mycobacterium tuberculosis has a primary drug-resistant bacteria or irregular medication secondary drug resistance, especially the emergence of isoniazid, rifampicin resistance, these two drugs are bactericides for the treatment of tuberculosis, drug resistance will appear poor therapeutic effect, pleural effusion is not absorbed, then you need to carry out drug sensitivity testing, according to the laboratory examination of the selection of sensitive drugs. Elderly tuberculous pleurisy with effusion can not be controlled, need to go to the hospital in time for follow-up, under the guidance of the doctor’s examination, treatment.