The World Health Organization (WHO) has published the 2018 update of its treatment guidelines for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB), which provides information on how to improve MDR/RR-TB care. TB strains with MDR/RR are more difficult to treat than drug-susceptible TB and threaten progress towards eradicating the disease globally.
The new recommendations, based on the most recent available evidence, suggest new approaches on how to treat MDR/RR-TB. Injectable agents kanamycin and capreomycin are no longer recommended for longer MDR-TB regimens. Fully oral regimens are the preferred option for most patients, while fluoroquinolones (levofloxacin or moxifloxacin), bedaquiline and linezolid are recommended in longer regimens.
Most regimens would include at least four agents likely to be effective in the first six months, then three thereafter. The proposed total duration of longer MDR-TB regimens is about 18-20 months.
Monitoring MDR-TB regimens with monthly culture offers the best option to detect a failing regimen in time for corrective action.
Detailed evidence summaries are available from the WHO.
Source: Eurosurveillance, 7 March 2019