Abstract
Over the past few decades, treatment of multidrug-resistant (MDR)/extensively drug-resistant (XDR) tuberculosis (TB) has been challenging because of its prolonged duration (up to 20–24 months), toxicity, costs and sub-optimal outcomes.
After over 40 years of neglect, two new drugs (bedaquiline and delamanid) have been made available to manage difficult-to-treat MDR-/XDR-TB cases. World Health Organization (WHO) guidelines published in March 2019 endorsed the possibility of treating MDR-TB patients with a full oral regimen, following previous guidelines published in 2016 which launched a shorter regimen lasting 9–10 months.
The objectives of this article are to review the main achievements in MDR-TB treatment through the description of the existing WHO strategies, to discuss the main ongoing trials and to shed light on potential future scenarios and revised definitions necessary to manage drug-resistant TB.
Abstract
The article reviews the evolution of the strategies and regimens to manage drug-resistant tuberculosis, opening a window on future perspectives. http://bit.ly/2Q1Rhx0
Footnotes
Submitted article, peer reviewed.
Author contributions: All the authors made substantial contributions to the conception, design and drafting of the article and have seen and agreed to the submitted version of the paper.
Conflict of interest: E. Pontali has nothing to disclose.
Conflict of interest: M.C. Raviglione has nothing to disclose.
Conflict of interest: G.B. Migliori has nothing to disclose.
Support statement: This article belongs to the scientific activities of the WHO Collaborating Centre for Tuberculosis and Lung Diseases, Tradate, ITA-80, 2017-2020- GBM/RC/LDA.
- Received April 3, 2019.
- Accepted April 28, 2019.
- Copyright ©ERS 2019.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.