Rapid Communication: Key changes to the treatment of drug-resistant tuberculosis (2019)

Significant improvements in treatment outcomes and quality of life for patients with drug-resistant tuberculosis are expected, following key updates to treatment approaches, announced by the World Health Organization (WHO) in a Rapid Communication.

Treatment success for multidrug-resistant and rifampicin resistant (MDR/RR) -TB is currently low in many countries. This could be increased by improving access to new regimens that are more effective, less toxic and easier to implement for eligible patients. In November 2019, WHO convened a meeting of its Guideline Development Group to update WHO Consolidated Guidelines on the treatment of drug-resistant TB, based on new evidence shared by countries, research and technical partners, and through responses to the public call for data.

The changes suggested by the evidence review are the phasing out of shorter injectable containing regimens and the introduction of a shorter all-oral bedaquiline containing regimen for eligible MDR/RR-TB patients. In addition, in patients with extensively drug resistant (XDR) -TB, a shorter regimen with bedaquiline, pretomanid and linezolid may be used under operational research conditions as an alternative to the longer regimen.

This Rapid Communication has been released in advance of the updated guidelines expected in 2020, to inform national TB programmes and other stakeholders about the key implications for treatment of MDR/RR-TB and XDR-TB in order to allow for rapid transition and planning at the country level.