Abstract To study the treatment of refractory pulmonary tuberculosis and to provide effective treatment for relapsed and drug-resistant tuberculosis patients, levofloxacin was used as the base drug and two to three of the following drugs were selected according to the patient’s specific situation: INH, RFT, PZA, S.M, PAS, amikacin, EMTh1321. 24 patients were treated intensively with the above regimen for 3 months and the treatment was based on the efficacy The drugs were established for consolidation therapy. The results were clinically controlled in 19 patients, with 4 cases of significant effect and 1 case of progress, with an effective rate of 95.8%. The tuberculosis positive before the course of treatment were all turned negative within 1~2 months of medication, suggesting that the number of retreatment and drug-resistant cases is increasing among the patients seen for pulmonary tuberculosis, making it difficult to treat pulmonary tuberculosis with conventional medication in clinical practice. In our group, 24 cases of refractory pulmonary TB were treated with levofloxacin combined with intensive therapy to achieve better results. The combination of levofloxacin and intensive therapy in our group of 24 cases with refractory pulmonary tuberculosis provided a new clinical treatment option. Discussion In the past decade or so, the global tuberculosis epidemic has rebounded, and the increasing number of relapsed and drug-resistant cases among patients with tuberculosis seen in hospitals, as well as the inability of some first-treatment patients to tolerate the adverse effects of drugs, have made the conventional clinical treatment of tuberculosis with drugs for tuberculosis challenging. In this group, 19 patients (83%) were retreated. The reasons for retreatment include irregular drug use in the past, recurrent tuberculosis, significant adverse reactions after drug use, and multidrug-resistant tuberculosis infection. Levofloxacin is a broad-spectrum, high-efficiency fluoroquinolone drug, which has been widely used for the treatment of a variety of bacterial infections since its introduction. Because of the good antitubercular activity of fluoroquinolones, successful treatment of pulmonary tuberculosis with ciprofloxacin or ofloxacin-containing regimens has been reported in the 1980s, and because levofloxacin has better antitubercular activity and higher bioavailability than ofloxacin, and The clinical pharmacology showed that the drug had good bactericidal and bacteriostatic effects on tuberculosis bacteria inside and outside macrophages, and its MIC 0.25ug/ml and MBC 1.0ug/ml were lower than that of of ofloxacin. For this reason, we applied LVLXL in combination with other anti-TB drugs still clinically available to intensify the treatment of clinically refractory TB patients with significant anti-TB effects. Conventional anti-TB drugs have more adverse effects, especially RFP, pyrazinamide (PZA), and INH can produce adverse reactions to the organism and even lead to discontinuation. In this group, adverse reactions led to two cases in which the patients had difficulty tolerating the medication, and the LVLXL-based regimen avoiding RFP, PEA, or INH was used so that the patients’ anti-TB treatment was not interrupted and recent efficacy was achieved. Because of the small adverse effects of levofloxacin, those with adverse reactions were not rare in this group and could continue with the drug after minor symptomatic management. According to the above results, the combination of other anti-tuberculosis drugs with LVLXL can be used in the treatment of refractory pulmonary tuberculosis in the clinic and achieve recent efficacy. Moreover, it is one of the options for chemotherapy of clinically refractory pulmonary tuberculosis because of its low adverse effects.