Quinolones News

#4 May 2, 2017

Latest WHO treatment guidelines for drug-resistant tuberculosis

Antimicrobial resistance is an important global health issue, and is a particular concern in tuberculosis (TB), due to the need for long duration therapeutic regimens utilising multiple agents. Patients with TB caused by drug-resistant pathogens, particularly rifampicin-resistant TB (RR-TB), require regimens of even longer duration, making them more costly, toxic and complicated to deliver.

The World Health Organization (WHO) estimates that 3.9% of previously untreated and 21% of previously treated TB cases occurring worldwide in 2015 had multidrug or rifampicin-resistant TB (MDR/RR-TB), with reports that only about a half of these patients achieved successful treatment.

WHO has developed evidence-based clinical and policy guidelines for the treatment of drug-resistant TB using independent experts with broad technical and clinical expertise, along with public health experts to provide peer-review. The 2016 guidelines found that previously untreated patients receiving short-course MDR-TB regimens were more likely to achieve clinical success (84%) than those on longer regimens (62%). This led to the recommendation of a standardised 9-12 month short regimen as a first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents.

Researchers concluded that this main change from previous guidelines provided a shorter, more easily administered regimen. They stressed that while shorter MDR-TB regimens have now become the first choice for eligible MDR/RR-TB patients, it is important to consider regional resistance profiles. This latest revision highlighted the need for continuing research and monitoring of resistance.

PMID: 28331043

Eur Respir J. 2017 Mar 22;49(3). pii: 1602308. doi: 10.1183/13993003.02308-2016.

Source: https://www.ncbi.nlm.nih. gov/pubmed/28331043?dopt=Abstract

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