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
...Definitions...
Summary of Good Practices
...Summary...
Treatment
...Treatm...
...For t...
...using at least five drugs in the intensive phas...
...ntensive-phase duration of treatment of between 5...
...tal treatment duration of between 15 and 21...
...tients with pre-extensively drug-resistant TB...
...For the sele...
...mend including a later-generation fluoroquin...
...including bedaquiline. (S, VL)6...
...est including linezolid. (C,...
...suggest including clofazimine....
...t including cycloserine. (C, VL)620...
...gest including ethambutol only when...
...st including pyrazinamide in a regimen for tr...
...nel was unable to make a clinical recommendation...
...For selec...
...recommend NOT including amoxicillin-cl...
...NOT including the macrolides azithromyc...
...ncluding ethionamide/prothionamide if more...
...est NOT including p-aminosalicylic acid in a re...
...Fo...
...e suggest including amikacin or str...
...including a carbapenem (always to be use...
...gest NOT including kanamycin or capreomycin....
...For the use of the W...
...e shorter-course regimen is standardi...
...For the role of surgery in...
We suggest elective partial lung resecti...
...suggest medical therapy alone, rather than includ...
...For the t...
...ng a later-generation fluoroquinolone...
...with isoniazid-resistant TB treated with a daily r...
...For t...
...st offering treatment for latent TB...
...ble 1. Summary of Recommendations on Drugs fo...
...le 2a. Clinical Strategy to Build an Individualiz...
...Doses of Drugs for Treatment of Adults an...
...ble 3. Select Antiretroviral and Non–...