Table 1.
TB treatment regimens used in Uzbekistan.
| Type of TB | Category | Previous Guidelines | New Guidelines |
|---|---|---|---|
| DS-TB | New | 2HRZE/4HR | 2HRZE/4HR |
| Previously treated | 3HRZE/5HRE | 2HRZE/4HR | |
| MonoDR-TB | New | 3R-Z-E-Km-Lfx/6R-Z-E-Lfx | 6R-Z-E-Lfx |
| Previously treated | 3R-Z-E-Km-Lfx/6R-Z-E-Lfx | 9R-Z-E-Lfx-Lzd | |
| PDR-TB | HE-resistance | 3R-Z-E-Km-Lfx/6R-Z-E-Lfx | 3Am-R-Z-Lfx-Lzd/9R-Z-Lfx-Lzd |
| HZ-resistance | 3R-Z-E-Km-Lfx/6R-Z-E-Lfx | 3Am-R-E-Lfx-Lzd/9R-E-Lfx-Lzd | |
| HZE-resistance | 3R-Z-E-Km-Lfx/6R-Z-E-Lfx | MDR-TB treatment | |
| MDR/RR-TB | Short course regimen | 4-6Km-Mfx-Cfz-Pto-Z-E-HH/ 5Mfx-Cfz-Pto-Z-E |
4-6Km-Mfx-Cfz-Pto-Z-E-HH/ 5Mfx-Cfz-Pto-Z-E |
| Standard long Regimen |
8Km/Cm-Lfx-CS/PAS-Pto-Z-E/ 16Lfx-Cs/PAS-Pto-Z-E |
Middle risk group 20Bdq-Lfx-Lzd-Cfz-Cs High risk group 20Bdq-Dlm-Lzd-Cfz-Cs High risk group According to DST, individual |
|
| Pre-XDR-TB | Resistance to FQ | 8Km/Cm-6Bdq-Lzd-Cfz-Z-Pto-Cs/ 16Lzd-Cfz-Z-Pto-Cs |
|
| Resistance to SLI | 6Bdq-Mfx-Lzd-Cfz-Z-Pto-Cs/ 18Mfx-Lzd-Cfz-Z-Pto-Cs |
||
| XDR-TB | All | 12Bdq-Lzd-Cfz-Imp/cln-Amx/clv-Pto-Cs/12Mfx-Lzd-Cfz-Pto-Cs |
DS-TB = drug-susceptible TB; MonoDR-TB = isoniazid mono-resistance; PDR-TB = polydrug-resistant TB which is resistant first line drugs other than rifampicin; MDR/RR-TB = multidrug resistant TB, resistant to isoniazid and rifampicin and rifampicin resistant TB; pre-XDR-TB = MDR-TB with either resistance to fluoroquinolones or injectable aminoglycosides/capreomycin; XDR-TB = MDR-TB with resistance to fluoroquinolones and injectable aminoglycosides/capreomycin. Several treatment options for MDR/RR-TB and pre-XDR-TB are being tested in Uzbekistan under operational research conditions. The numbers preceding the treatment regimen indicates the number of months of treatment. Middle and high risk groups indicate level of risk of treatment failure. H = isoniazid; HH = high dose isoniazid; R = rifampicin; Z = pyrazinamide; E = ethambutol; Am = amikacin; Km = kanamycin; Lfx = levofloxacin; Lzd = linezolid; Mfx = moxifloxacin; Cfz = clofazamine; Pto = prothionamide; CS = cycloserine; PAS = para-amino salicylic acid; Bdq = bedaquiline; Imp/cln = imipenem-cilastatin; Amx/clv = amoxicillin-clavulanic acid; dlm = delaminid; FQ = fluoroquinolones; SLI = Second-line injectables.