Treatment of Drug-Resistant Tuberculosis
Key Points
Key Points
MDR-TB is defined specifically as resistance to at least isoniazid and rifampin, the two most important first-line drugs.
The guideline is intended for settings in which treatment is individualized and where mycobacterial cultures, molecular (genotypic) and culture-based (phenotypic) drug susceptibility tests (DSTs), and radiographic facilities are available.
Treatment success was most likely with regimens for MDR-TB containing 5 effective drugs in the intensive phase. Mortality was also significantly reduced for those taking 5 or 6 effective drugs.
Definitions
...ns...
Summary of Good Practices
...Good Practices...
Treatment
Treatment
...ction of an effective MDR-TB treatmen...
...sing at least five drugs in the inten...
...n intensive-phase duration of treatment of bet...
...gest a total treatment duration of between 15 and...
...patients with pre-extensively drug-resistant TB...
...lection of oral drugs for MDR-TB tr...
...d including a later-generation fluoroquinolone...
...commend including bedaquiline. (S, VL...
...e suggest including linezolid. (C, V...
...including clofazimine. (C, VL)620
...uggest including cycloserine. (C, VL)620...
...including ethambutol only when other mor...
...t including pyrazinamide in a regimen...
...ne panel was unable to make a clinical recomme...
For selected oral drugs previously included i...
We recommend NOT including amoxici...
...including the macrolides azithromycin...
...st NOT including ethionamide/prothionamide if...
...NOT including p-aminosalicylic acid in a regim...
...r the selection of drugs administered t...
...suggest including amikacin or streptomycin when...
...luding a carbapenem (always to be used with amoxic...
...suggest NOT including kanamycin or...
...use of the WHO-recommended standardized sho...
...ourse regimen is standardized with th...
...of surgery in the treatment of MDR-TB:...
...uggest elective partial lung resection (e.g.,...
...est medical therapy alone, rather than includ...
...the treatment of isoniazid-resistant TB:
...uggest adding a later-generation fluoroquinolone t...
...patients with isoniazid-resistant TB...
...he management of contacts to patients with...
...est offering treatment for latent TB infec...
...Summary of Recommendations on Drugs...
.... Clinical Strategy to Build an Individual...
Table 2b. Doses of Drugs for Treatment of Adults a...
...t Antiretroviral and Non–rifamycin-based Ant...