Multi-drug resistant tuberculosis (MDR-TB) is an important and growing problem in many developing countries. New strategies have been developed to combat the disease but require complex treatment regimens and close monitoring of patients' bacteriology results. We describe a web-based medical record system deployed in Peru to support the management of MDR-TB. Web-based analyses have been developed to track drug sensitivity test results, patterns of sputum smear and culture results and time to conversion from positive to negative cultures. Individual and aggregate drug requirements can also be monitored in real time. Multiple analyses can be linked together and data can be graphed or downloaded to spreadsheets. Over 1200 patients are currently in the system. We argue that such a web-based clinical and epidemiological management system is an important component for successful implementation of complex health interventions in resource poor areas.