DOTS-PLUS
|
2000 |
|
|
[6, 7] |
Guidelines for the programmatic management of drug-resistant TB
|
2006 |
Management of MDR-TB to be integrated into comprehensive national TB control plans
First “modern” categorisation of drugs used to treat MDR-TB into five groups
Options for tailoring diagnosis and care to different epidemiological and programmatic conditions worldwide
|
18 months after culture conversion |
[9] |
Guidelines for the programmatic management of drug-resistant TB: emergency update
|
2008 |
Definition of XDR and acknowledgement of this threat
Recommendations on drug resistant management
Introduction of rapid DST
|
|
[10] |
WHO guidelines for the programmatic management of drug-resistant TB: 2011 update
|
2011 |
Importance of rapid DST stressed
Regimens including at least four, and ideally five, drugs likely to be effective
Drugs to be included are a FLQ, an injectable agent, ethionamide or prothionamide, PZA and either cycloserine or para-amniosalicylic acid. Other drugs such as EMB or group 5 drugs could be added, but they should not be counted among the four effective drugs
|
20 months (with an 8-month intensive phase) |
[11] |
WHO consolidated guidelines on drug-resistant TB treatment
|
2019 |
Continued recommendation of using shorter regimen whenever possible
If using injectables use amikacin
Drugs reclassified into three groups (A, B and C) for the purpose of composing the longer regimen:
Group A includes three drugs to be prioritised and used, if possible, in all regimens: levofloxacin/moxifloxacin, BDQ and LZD
Group B includes two drugs to be possibly added to all regimens (CFZ and cycloserine/terizidone)
Group C includes “other” agents (including injectables) to be used as a substitute to complete a regimen of at least four drugs when agents from groups A and B cannot be used
|
Longer regimen: may be standardised or individualised; duration 18–20 months, modified depending upon patient response Shorter regimen: 9–12 months |
[32] |