WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update
Dennis Falzon,Ernesto Jaramillo,Holger J. Schünemann,Matthew Arentz,Melissa Bauer,Jaime Bayona,Léopold Blanc,Jose A. Caminero,Charles L. Daley,Chris Duncombe,Christopher Fitzpatrick,Agnes Gebhard,Haileyesus Getahun,Myriam Henkens,Timothy H. Holtz,J. Keravec,S. Keshavjee,Aamir J. Khan,R. Kulier,Vaira Leimane,Christian Lienhardt,Chunling Lu,Mar'iandyshev Ao,Giovanni Battista Migliori,Fuad Mirzayev,Carole D. Mitnick,Paul Nunn,G. Nwagboniwe,Olivia Oxlade,Domingo Palmero,Patricia B Pavlinac,M. I. D. Quelapio,Mario C. Raviglione,Michael Rich,S. Royce,Sabine Rüsch-Gerdes,A. Salakaia,R. Sarin,Delphine Sculier,Francis Varaine,Marco Vitoria,Judd L. Walson,Fraser Wares,Karin Weyer,Richard A. White,Matteo Zignol +45 more
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TLDR
The guidelines promote the early use of antiretroviral agents for TB patients with HIV on second-line drug regimens and systems that primarily employ ambulatory models of care are recommended over others based mainly on hospitalisation.Abstract:
The production of guidelines for the management of drug-resistant tuberculosis (TB) fits the mandate of the World Health Organization (WHO) to support countries in the reinforcement of patient care. WHO commissioned external reviews to summarise evidence on priority questions regarding case-finding, treatment regimens for multidrug-resistant TB (MDR-TB), monitoring the response to MDR-TB treatment, and models of care. A multidisciplinary expert panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. The recommendations support the wider use of rapid drug susceptibility testing for isoniazid and rifampicin or rifampicin alone using molecular techniques. Monitoring by sputum culture is important for early detection of failure during treatment. Regimens lasting ≥ 20 months and containing pyrazinamide, a fluoroquinolone, a second-line injectable drug, ethionamide (or prothionamide), and either cycloserine or p-aminosalicylic acid are recommended. The guidelines promote the early use of antiretroviral agents for TB patients with HIV on second-line drug regimens. Systems that primarily employ ambulatory models of care are recommended over others based mainly on hospitalisation. Scientific and medical associations should promote the recommendations among practitioners and public health decision makers involved in MDR-TB care. Controlled trials are needed to improve the quality of existing evidence, particularly on the optimal composition and duration of MDR-TB treatment regimens.read more
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Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa
Neel R. Gandhi,Neel R. Gandhi,Anthony P. Moll,A. Willem Sturm,Robert Pawinski,Thiloshini Govender,Umesh G. Lalloo,Kimberly Zeller,Kimberly Zeller,Jason R. Andrews,Gerald Friedland +10 more
TL;DR: MDR tuberculosis is more prevalent than previously realised in a rural area in KwaZulu Natal, South Africa and has been transmitted to HIV co-infected patients and is associated with high mortality.
Journal ArticleDOI
Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.
Payam Nahid,Susan E. Dorman,Narges Alipanah,Pennan M. Barry,Jan Brozek,Adithya Cattamanchi,Lelia H. Chaisson,Richard E. Chaisson,Charles L. Daley,M. Grzemska,Julie Higashi,Christine S Ho,Philip C. Hopewell,Salmaan Keshavjee,Christian Lienhardt,Richard Menzies,Cynthia Merrifield,Masahiro Narita,Rick O'Brien,Charles A. Peloquin,Ann Raftery,Jussi J. Saukkonen,H. Simon Schaaf,Giovanni Sotgiu,Jeffrey R. Starke,Giovanni Battista Migliori,Andrew Vernon +26 more
TL;DR: This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis.
Journal ArticleDOI
Advances in the development of new tuberculosis drugs and treatment regimens
TL;DR: Current concepts and recent advances in TB drug discovery and development are covered, including an update of ongoing TB treatment trials, newer clinical trial designs, TB biomarkers and adjunct host-directed therapies.
Journal ArticleDOI
Towards tuberculosis elimination: an action framework for low-incidence countries
Knut Lönnroth,Giovanni Battista Migliori,Ibrahim Abubakar,Lia D'Ambrosio,Gerard De Vries,Roland Diel,Paul Douglas,Dennis Falzon,Marc Andre Gaudreau,Delia Goletti,Edilberto R. González Ochoa,Philip A. LoBue,Alberto Matteelli,Howard Njoo,Ivan Solovic,Alistair Story,Tamara Tayeb,Marieke J. van der Werf,Diana Weil,Jean-Pierre Zellweger,Mohamed Abdel Aziz,Mohamed R.M. Al Lawati,Stefano Aliberti,Wouter Arrazola de Oñate,Draurio Barreira,Vineet Bhatia,Francesco Blasi,Amy Bloom,Judith Bruchfeld,Francesco Castelli,Rosella Centis,Daniel Chemtob,Daniela Maria Cirillo,Alberto Colorado,Andrei Dadu,Ulf R Dahle,Laura De Paoli,Hannah Monica Yesudian Dias,Raquel Duarte,Lanfranco Fattorini,Mina Gaga,Haileyesus Getahun,Philippe Glaziou,Lasha Goguadze,Mirtha del Granado,Walter Haas,Asko Järvinen,Geun Yong Kwon,Davide Mosca,Payam Nahid,Nobuyuki Nishikiori,I. Noguer,Joan O'Donnell,Analita Pace-Asciak,Maria Grazia Pompa,Gilda Popescu,Carlos Robalo Cordeiro,Karin Rønning,Morten Ruhwald,Jean-Paul Sculier,Aleksandar Simunovic,Alison Smith-Palmer,Giovanni Sotgiu,Giorgia Sulis,Carlos A. Torres-Duque,Kazunori Umeki,Mukund Uplekar,Catharina Van Weezenbeek,Tuula Vasankari,Robert J. Vitillo,Constantia Voniatis,Maryse Wanlin,Mario C. Raviglione +72 more
TL;DR: An action framework for countries with low tuberculosis (TB) incidence sets out priority interventions required for these countries to progress first towards “pre-elimination” and eventually the elimination of TB as a public health problem.
Journal ArticleDOI
International standards for tuberculosis care.
TL;DR: The International Standards for Tuberculosis Care (ISTC) describe a widely endorsed level of care that all practitioners should seek to achieve in managing individuals who have, or are suspected of having, tuberculosis.
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