Abstract
The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) substantially challenges TB control, especially in the European Region of the World Health Organization, where the highest prevalence of MDR/XDR cases is reported. The current management of patients with MDR/XDR-TB is extremely complex for medical, social and public health systems. The treatment with currently available anti-TB therapies to achieve relapse-free cure is long and undermined by a high frequency of adverse drug events, suboptimal treatment adherence, high costs and low treatment success rates. Availability of optimal management for patients with MDR/XDR-TB is limited even in the European Region. In the absence of a preventive vaccine, more effective diagnostic tools and novel therapeutic interventions the control of MDR/XDR-TB will be extremely difficult. Despite recent scientific advances in MDR/XDR-TB care, decisions for the management of patients with MDR/XDR-TB and their contacts often rely on expert opinions, rather than on clinical evidence.
This document summarises the current knowledge on the prevention, diagnosis and treatment of adults and children with MDR/XDR-TB and their contacts, and provides expert consensus recommendations on questions where scientific evidence is still lacking.
Abstract
TBNET consensus statement on the management of patients with MDR/XDR-TB has been released in the Eur Respir J http://ow.ly/uizRD
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Support statement: This work was supported by the EU FP7 project TBPANNET (D.M. Cirillo and C. Lange), the German Center for Infection Research (DZIF) (C. Lange), the German Federal Ministry of Education and Research (D. Wagner), the UK Medical Research Council (I. Abubakar and B. Kampmann) and National Institute for Medical Research (I. Abubakar), and the National Institute of Health Research (UK) (B. Kampmann).
Conflict of interest: Disclosures can be found alongside the online version of this article at www.erj.ersjournals.com
- Received October 30, 2013.
- Accepted March 3, 2014.
- ©ERS 2014
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