TY - JOUR T1 - ERS/WHO Tuberculosis Consilium assistance with extensively drug-resistant tuberculosis management in a child: case study of compassionate delamanid use JF - European Respiratory Journal JO - Eur Respir J SP - 811 LP - 815 DO - 10.1183/09031936.00060414 VL - 44 IS - 3 AU - Susanna Esposito AU - Lia D’Ambrosio AU - Marina Tadolini AU - H. Simon Schaaf AU - Josè Caminero Luna AU - Ben Marais AU - Rosella Centis AU - Masoud Dara AU - Alberto Matteelli AU - Francesco Blasi AU - Giovanni Battista Migliori Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/3/811.abstract N2 - To the Editor:The European Respiratory Society (ERS) and the World Health Organization (WHO) Regional Office for Europe implemented a consultation body, the ERS/WHO Tuberculosis (TB) Consilium, in late April 2013 [1–4]. This is a novel, high-priority initiative, as part of the 2012–2013 Presidential plan, to face the growing problem of drug-resistant TB in Europe and globally to support clinicians in managing difficult-to-treat TB cases.Clinicians are increasingly challenged by difficult-to-treat cases of multidrug-resistant (MDR)-TB (i.e. TB caused by Mycobacterium tuberculosis strains resistant to isoniazid and rifampicin) and extensively drug-resistant (XDR)-TB (i.e. TB caused by MDR-TB strains that are also resistant to at least one fluoroquinolone and one injectable second-line anti-TB drug) [5–8]. MDR/XDR-TB is seriously hampering TB control and elimination in Europe [9–11], as patients require long and expensive regimens with significant adverse effects, while cure rates remain low [7, 8, 12–14].Clinicians can upload a case description and queries via the ERS/WHO TB Consilium website (www.tbconsilium.org), the process of which takes up to 20 minutes. The case is then assigned to global experts who provide feedback to the clinician’s questions in a limited timeframe, free of charge. At the time of writing, the TB Consilium has provided expert opinion on 51 cases (and two outbreaks from 11 countries), with an average response time of 36 h. The most frequently posed questions are related to the design and duration of the most appropriate regimens for difficult-to-treat patients [4].In the absence of a sufficient number of medicines to which a strain is sensitive in vivo, life-saving treatment may rely on the use of new medicines (bedaquiline or delamanid) either under conditional or through compassionate use [15– … ER -