Guidelines for treatment of drug-susceptible tuberculosis and patient care
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World Health Organization
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80 p.
This WHO guideline updates evidence-based recommendations on the treatment of drug-susceptible tuberculosis (TB) and patient care in the context of the End TB Strategy. It revises the 2010 WHO treatment guidelines by incorporating new evidence on key clinical and programmatic questions while consolidating existing recommendations that remain valid. Developed using systematic reviews, GRADE methodology and expert review, the guideline is intended to support national TB programme managers, policy-makers and health professionals in making informed decisions across diverse health-care settings. The guideline presents recommendations on the management of drug-susceptible TB, including the continued use of the standard 6-month rifampicin-based regimen, fixed-dose combination formulations, daily dosing schedules, antiretroviral therapy initiation and treatment duration for people living with HIV, adjunctive corticosteroid therapy for selected forms of extrapulmonary TB, and the replacement of the former category II retreatment regimen with drug-susceptibility testing to guide therapy. It also introduces evidence-based recommendations on patient care and treatment support, including adherence interventions, community- and home-based models of directly observed treatment, video-observed treatment, and decentralized care for multidrug-resistant TB. The guideline outlines implementation considerations, identifies research priorities and summarizes recommendations from earlier WHO guidance that remain applicable.
This WHO guideline updates evidence-based recommendations on the treatment of drug-susceptible tuberculosis (TB) and patient care in the context of the End TB Strategy. It revises the 2010 WHO treatment guidelines by incorporating new evidence on key clinical and programmatic questions while consolidating existing recommendations that remain valid. Developed using systematic reviews, GRADE methodology and expert review, the guideline is intended to support national TB programme managers, policy-makers and health professionals in making informed decisions across diverse health-care settings. The guideline presents recommendations on the management of drug-susceptible TB, including the continued use of the standard 6-month rifampicin-based regimen, fixed-dose combination formulations, daily dosing schedules, antiretroviral therapy initiation and treatment duration for people living with HIV, adjunctive corticosteroid therapy for selected forms of extrapulmonary TB, and the replacement of the former category II retreatment regimen with drug-susceptibility testing to guide therapy. It also introduces evidence-based recommendations on patient care and treatment support, including adherence interventions, community- and home-based models of directly observed treatment, video-observed treatment, and decentralized care for multidrug-resistant TB. The guideline outlines implementation considerations, identifies research priorities and summarizes recommendations from earlier WHO guidance that remain applicable.