strong

Linezolid should be included in the treatment of MDR/RR-TB patients on longer regimens.

Levofloxacin or moxifloxacin should be included in the treatment of MDR/RR-TB patients on
longer regimens.

Health education and counselling on the disease and treatment adherence should
be provided to patients on tuberculosis (TB) treatment.

Antiretroviral therapy is recommended for all patients with HIV and drug-resistant tuberculosis requiring second-line antituberculosis drugs, irrespective of CD4 cell count, as early as possible (within the first 8 weeks) following initiation of antituberculosis treatment.

In multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB) patients on longer regimens, the performance of sputum culture in addition to sputum smear microscopy is recommended to monitor treatment response. It is desirable for sputum culture to be repeated at monthly intervals.

Clavulanic acid should not be included in the treatment of MDR/RR-TB patients on longer
regimens.

The panel recommends that evidence-based guidelines should be developed and
implemented for the purpose of reducing HAIs and AMR. The education and training of relevant
healthcare workers on the guideline recommendations and the monitoring of adherence with
guideline recommendations should be undertaken to achieve successful implementation.

Health care facility level:
The panel recommends that an IPC programme with a dedicated, trained team should be in
place in each acute healthcare facility for the purpose of preventing HAIs and combating AMR through IPC good practices.

Respiratory hygiene (including cough etiquette)
in people with presumed or confirmed TB
is recommended to reduce M. tuberculosis
transmission to health workers, persons
attending health care facilities or other persons
in settings with a high risk of transmission.

Prompt initiation of effective treatment of
people with TB disease is recommended
to reduce M. tuberculosis transmission to
health workers, persons attending health care
settings or other persons in settings with a
high risk of transmission.