Eligibility for shorter treatment of multidrug-resistant tuberculosis in the European Union

• Published in: The European respiratory journal Vol. 49; no. 3; p. 1601992
• Main Authors: van der Werf, Marieke J, Hollo, Vahur, Ködmön, Csaba, Dara, Masoud, Catchpole, Mike
• Format: Journal Article
• Language: English
• Published: England European Respiratory Society Journals Ltd 01.03.2017; European Respiratory Society
• Subjects: Agora; Antitubercular Agents - administration & dosage; Antitubercular Agents - therapeutic use; Bacilli; Clofazimine; Drug Administration Schedule; Ethambutol; European Union; Fluoroquinolones; Humans; Isoniazid; Kanamycin; Lung diseases; Moxifloxacin; Multidrug resistance; Multidrug resistant organisms; Mycobacterium; Mycobacterium tuberculosis - isolation & purification; Pregnancy; Pyrazinamide; Rifampin; Tuberculosis; Tuberculosis, Multidrug-Resistant - drug therapy; Tuberculosis, Multidrug-Resistant - epidemiology
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/13993003.01992-2016

In May 2016, the World Health Organization (WHO) updated its treatment guidelines for drug-resistant tuberculosis (TB) and included a recommendation for the use of the shorter multidrug-resistant (MDR) TB regimen [1]. The WHO update is based on information provided by observational studies coordinated by the International Union Against Tuberculosis and Lung Disease, Médecins sans Frontiéères and the Damien Foundation which showed that the shorter treatment regimen resulted in a higher likelihood of treatment success compared to the longer conventional treatment in the study settings [2–5]. The shorter MDR-TB regimen consists of a standardised treatment course lasting 9–12 months and includes kanamycin, moxifloxacin, prothionamide, clofazimine, pyrazinamide, isoniazid and ethambutol. It is recommended for patients with rifampicin-resistant (RR) or MDR-TB (cases with TB bacilli resistant to at least isoniazid and rifampicin) who have not been treated previously with second-line drugs and in whom resistance to fluoroquinolones and second-line injectable agents has been excluded or is considered highly unlikely. It is not recommended for pregnant women and patients with extrapulmonary TB.