WHO updates Guidelines on the treatment of
Drug-resistant Tuberculosis
On 15 December 2022, the World Health Organization released the much awaited update on the drug-resistant TB treatment! The 2022 update consists of the WHO Consoldated Guidelines and the Operational Handbook (Module 4) which supersedes the 2020 version.
The Consolidated Guidelines compiles all DR-TB recommendations in one documented based on the best practices and knowledge from the field. https://www.who.int/publications/i/item/9789240063129. It comes with the Operational Handbook that provides practical guidance on implementing the recommendations in National TB Programs. https://www.who.int/publications/i/item/9789240065116
WHO consolidated guidelines on tuberculosis (Module 4: Drug-resistant tuberculosis treatment, 2022 update)
The WHO Consolidated Guidelines on Tuberculosis (TB), Module 4: Treatment - Drug-Resistant Tuberculosis Treatment 2022 update informs health care professionals in Member States on how to improve treatment and care for patients with drug-resistant TB (DR-TB). This document includes two new recommendations – one for the use of a 6-month BPaLM regimen, composed of bedaquiline, pretomanid, linezolid and moxifloxacin in patients with multidrug-resistant or rifampicin resistant TB (MDR/RR-TB) and those with additional resistance to fluoroquinolones (pre-XDR-TB) and another for a 9-month all oral regimen in patients with MDR/RR-TB and in whom resistance to fluoroquinolones has been excluded. In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB, longer all oral regimens, monitoring of treatment response, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV) and the use of surgery for patients receiving MDR-TB treatment.
The WHO Consolidated Guidelines on Tuberculosis group all DR-TB recommendations in one document and are complemented by matching modules of the consolidated operational handbook.
TB is one of the leading infectious causes of death globally. Drug-resistant TB remains a public health crisis.
This article and handbook can be found/downloaded in this link: https://www.who.int/publications/i/item/9789240063129
WHO operational handbook on tuberculosis (Module 4: Drug-resistant tuberculosis treatment, 2022 update)
The WHO Operational Handbook on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact. The consolidated guidelines are complemented by this operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB.
The operational handbook provides practical information and tools that complement the recommendations in the guidelines based on best practices and knowledge from the field such as microbiology, clinical and programmatic management. It includes information on different aspects of treatment and care of DR-TB, including multidrug-resistant or rifampicin resistant TB (MDR/RR-TB) and rifampicin susceptible isoniazid resistant TB (Hr-TB). The handbook provides practical guidance on the implementation of the new recommendations on the use of the 6-month BPaLM regimen, and the 9-month all oral regimen and rationale for selection of the most appropriate regimen. In addition, the handbook includes key considerations for design and implementation of the all-oral longer regimens.
This practical guidance includes a consolidated table on weight-based dosing of medicines used in multidrug-resistant TB regimens for adults and children. Besides, there are chapters on adjuncts to DR-TB treatment, the use of antiretrovirals for MDR/RR-TB patients with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment and monitoring treatment response tied to the updated treatment outcome definitions.
This article and handbook can be found/downloaded in this link: https://www.who.int/publications/i/item/9789240065116