WHO GUIDELINES 2022 – For Drug Resistant Tuberculosis
WHO in a landmark move has updated the initial treatment regime for all eligible people diagnosed with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB).
The recommendation includes a shorter
6-month regime comprising bedaquiline (Bdq), pretomanid, linezolid (Lzd) and moxifloxacin (Mfx) i.e BPaLM. The previous longer 9-month BPaL regime is recommended only in those patients with proven fluoroquinolone resistance.
The update also includes a short 9-month regime in cases where BPaLM regime is unavailable, implementation of the regimen is not feasible, or patients are not eligible (pregnancy and lactation etc.). It comprises of:
Initial phase (4-6 months): Bdq+ Lfx/Mfx + Cfz+ Z +E+ Hh+ Lzd (2 months)/ Eto
Continuation phase (5 months): Lfx/Mfx + Cfz+ Z+E
Although WHO has recommended the above regimes, the regimes are yet to be implemented by NTEP India and are under trial only in select districts.
*Lfx: Levofloxacin, Cfz: Clofazamine, Z:
Pyrazinamide, E: Ethambutol, Hh: Isoniazide (high dose), Eto: Ethionamide
Reference:
https://www.who.int/publications/i/item/9789240063 129,
https://www.who.int/news/item/15-12-2022-who-announces -landmark-changes-in-treatment-of-drug-resistant-tuberculosis
WHO GUIDELINES 2022 – For Drug Resistant Tuberculosis
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