Alignment of New Tuberculosis Drug Regimens and Drug Susceptibility Testing: a Framework for Action

Overview

Journal Lancet Infect Dis

Specialty Infectious Diseases

Date 2013 Mar 28

PMID 23531393

Citations 31

Authors

William A Wells

Catharina C Boehme

Frank G J Cobelens

Colleen Daniels

David Dowdy

Elizabeth Gardiner

Jan Gheuens

Peter Kim

Michael E Kimerling

Barry Kreiswirth

Christian Lienhardt

Khisi Mdluli

Madhukar Pai

Mark D Perkins

Trevor Peter

Matteo Zignol

Alimuddin Zumla

Marco Schito

Affiliations

Soon will be listed here.

Abstract

New tuberculosis drug regimens are creating new priorities for drug susceptibility testing (DST) and surveillance. To minimise turnaround time, rapid DST will need to be prioritised, but developers of these assays will need better data about the molecular mechanisms of resistance. Efforts are underway to link mutations with drug resistance and to develop strain collections to enable assessment of new diagnostic assays. In resource-limited settings, DST might not be appropriate for all patients with tuberculosis. Surveillance data and modelling will help country stakeholders to design appropriate DST algorithms and to decide whether to change drug regimens. Finally, development of practical DST assays is needed so that, in countries where surveillance and modelling show that DST is advisable, these assays can be used to guide clinical decisions for individual patients. If combined judiciously during both development and implementation, new tuberculosis regimens and new DST assays have enormous potential to improve patient outcomes and reduce the burden of disease.

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