Updated guidelines from the World Health Organization (WHO) on the management of drug-resistant tuberculosis (TB) are intended to help inform practitioners, particularly those in lower-income settings, of the very latest and most cost-effective standards of care for achieving optimal patient outcomes, says a Medscape Medical News article.
The guidelines reflect the recommendations of a multidisciplinary panel of TB practitioners, public health professionals, representatives of professional societies, national TB control program staff, guideline methodologists, and other professionals.
Although there are no radical changes from WHO's 2008 guidance, Medscape says, the updated guidelines include some important adjustments and provide the most updated information on issues such as diagnosis, treatment, and monitoring. The recommendations include a focus on cost-effective ambulatory models of care that treat patients outside of the hospital, reducing the risk for re-infection and decreasing travel and social isolation for patients. For patients with multi-drug resistant TB, the guidelines extend the minimum duration of treatment by 2 months to reflect research showing improved treatment success with the longer duration. Intensive treatment should therefore last at least 8 months. For patients who have not been treated with second-line drugs for TB in the past, treatment should extend to 20 months. The duration may be adjusted for some patients according to their clinical and bacteriologic response.
The guidelines are available online in European Respiratory Journal.