Treatment

Effective treatment of TB, including its drug-resistant forms, relies on the use of several medicines administered in combination for an adequate duration. Significant progress has been made in recent years in identifying more efficacious, safer medicines and shorter treatment regimens. Since the 1990s, WHO has regularly evaluated evidence on the use of specific drug compositions and combinations of regimens of different durations (2, 9–16). Historically, patients with certain drugresistance patterns were often treated for 20 months or longer.

The recommendations part of this chapter has eight sections that cover aspects of the treatment of DR-TB. The aspects covered are:

Tuberculosis (TB) strains that are resistant to TB medicines are more difficult to treat than drugsusceptible ones, and present a major challenge for patients, health care workers and health care services. In addition, the increase of drug-resistant TB (DR-TB) threatens global progress towards the targets set by the End TB Strategy (1) of the World Health Organization (WHO).

1. Guidelines for treatment of drug-susceptible tuberculosis and patient care, 2017 update (WHO/HTM/TB/2017.05). Geneva: World Health Organization; 2017 (https://apps.who.int/iris/bitstream/handle/10665/255052/9789241550000-eng.pdf).
2. Treatment of tuberculosis, guidelines for national programmes, fourth edition (WHO/HTM/TB/2009.420).

The GDGs discussed future research and highlighted a number of priorities.

Recommendation 4.1

Recommendation 4.2

Recommendation 3.1

Source of recommendation

Recommendation 2.1

Source of recommendation

This recommendation was developed following the advice of the GDG convened in April 2021 to review data from a randomized controlled trial that assessed the safety and effectiveness of 4-month regimens for the treatment of DS-TB.