Treatment of Drug-Resistant Tuberculosis

Publication Date: November 15, 2019

Key Points

Key Points

In this pocket guide, the guideline committee provides new recommendations for treatment of multiple drug-resistant tuberculosis (MDR-TB) and for treatment of isoniazid-resistant-TB.

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 of G...

Treatment

...Treatment...

...For the selec...

...t using at least five drugs in the int...

...st an intensive-phase duration of...

We suggest a total treatment duration...

...with pre-extensively drug-resistant TB...


...For...

...luding a later-generation fluoroquinolone (levofl...

...e recommend including bedaquiline. (S,...

...suggest including linezolid....

...including clofazimine. (C, VL)620...

...cluding cycloserine. (C, VL)620

We suggest including ethambutol only when...

...ncluding pyrazinamide in a regimen for treatment...

The guideline panel was unable to make a...


...For selecte...

...e recommend NOT including amoxicillin-...

...d NOT including the macrolides azithromyci...

...suggest NOT including ethionamide/prothionami...

...T including p-aminosalicylic acid in a...


...For the selec...

...cluding amikacin or streptomycin when su...

...uding a carbapenem (always to be used with amoxi...

...ggest NOT including kanamycin or cap...


...For the use o...

...rse regimen is standardized with the use...


...ctive partial lung resection (e.g., lobect...

...edical therapy alone, rather than including elect...


For t...

We suggest adding a later-generation fluoroquinol...

...h isoniazid-resistant TB treated with a daily...


...For the management of...

...ggest offering treatment for latent TB infection (...


...mmary of Recommendations on Drugs for Use in...


...2a. Clinical Strategy to Build an Indiv...


...able 2b. Doses of Drugs for Treatmen...


...lect Antiretroviral and Non–rifamycin-based An...