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
...ions...
Summary of Good Practices
...ood Practices...
Treatment
...atment...
For the selection of an effective MDR-TB tr...
...t using at least five drugs in the intensive ph...
...t an intensive-phase duration of tre...
...total treatment duration of between 15 and...
...tients with pre-extensively drug-resistant TB (p...
...election of oral drugs for MDR-TB treat...
...ecommend including a later-generation fluoro...
...cluding bedaquiline. (S, VL)620...
...including linezolid. (C, VL)620...
...including clofazimine. (C, VL)620...
...luding cycloserine. (C, VL)620...
...t including ethambutol only when other more effe...
...suggest including pyrazinamide in a regimen...
...guideline panel was unable to make a c...
...ral drugs previously included in regimens for the...
...mend NOT including amoxicillin-clavulanate, with t...
...mmend NOT including the macrolides azithr...
...t NOT including ethionamide/prothionamide if m...
...est NOT including p-aminosalicylic acid...
...the selection of drugs administered t...
...e suggest including amikacin or stre...
...luding a carbapenem (always to be used with...
...ncluding kanamycin or capreomycin....
...the WHO-recommended standardized...
...orter-course regimen is standardized with the use...
...surgery in the treatment of MDR-TB:...
...ggest elective partial lung resection (e.g...
...e suggest medical therapy alone, rather...
...ment of isoniazid-resistant TB:...
...ggest adding a later-generation fluoroquinolone...
...h isoniazid-resistant TB treated with a d...
...agement of contacts to patients with MDR-TB:...
...suggest offering treatment for latent TB infe...
...Summary of Recommendations on Drugs for Use in a...
...al Strategy to Build an Individualized Treatm...
...e 2b. Doses of Drugs for Treatment of Adults and...
...Antiretroviral and Non–rifamycin-b...