RT Journal Article
SR Electronic
T1 World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1602308
DO 10.1183/13993003.02308-2016
VO 49
IS 3
A1 Falzon, Dennis
A1 Schünemann, Holger J.
A1 Harausz, Elizabeth
A1 González-Angulo, Licé
A1 Lienhardt, Christian
A1 Jaramillo, Ernesto
A1 Weyer, Karin
YR 2017
UL http://erj.ersjournals.com/content/49/3/1602308.abstract
AB Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9–12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016. The composition of longer regimens for patients ineligible for the shorter regimen was modified. A first-ever meta-analysis of individual paediatric patient data allowed treatment recommendations for childhood MDR/RR-TB to be made. Delamanid is now also recommended in patients aged 6–17 years. Partial lung resection is a recommended option in MDR/RR-TB care. The 2016 revision highlighted the continued shortage of high-quality evidence and implementation research, and reiterated the need for clinical trials and best-practice studies to improve MDR/RR-TB patient treatment outcomes and strengthen policy.The latest WHO recommendations for the treatment of multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) http://ow.ly/Lj5K307XZ7h