Treatment of MDR, Pre-XDR, XDR, and Rifampicin-Resistant Tuberculosis or in Case of Intolerance to at Least Rifampicin in Austria, Germany, and Switzerland

Overview

Journal Respiration

Publisher Karger

Specialty Pulmonary Medicine

Date 2024 May 29

PMID 38810608

Authors

Ralf Otto-Knapp

Torsten Bauer

Folke Brinkmann

Cornelia Feiterna-Sperling

Inna Friesen

Hilte Geerdes-Fenge

Pia Hartmann

Brit Hacker

Jan Heyckendorf

Martin Kuhns

Christoph Lange

Florian P Maurer

Albert Nienhaus

Martin Priwitzer

Elvira Richter

Helmut J F Salzer

Otto D Schoch

Nicolas Schonfeld

Tom Schaberg

Affiliations

Soon will be listed here.

Abstract

Based on the assessment of new evidence, the World Health Organization (WHO) updated its guidelines for the treatment of drug-resistant tuberculosis (TB) in December 2022. The new recommendations and the latest study data made it necessary to update the existing guideline on the treatment of at least rifampicin-resistant TB (RR-TB) for the German-speaking countries, replacing the respective chapters of the treatment guidelines published in 2022. A shortened treatment of proven RR-TB and multidrug-resistant TB for at least 6 months using the fixed and non-modifiable drug combination of bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM) is now also recommended for Austria, Germany, and Switzerland under certain conditions considering the existing barriers for the implementation of the new treatment regimen. For the treatment of pre-extensively drug-resistant (pre-XDR-) TB, an individualized treatment for 18 months continues to be the primary recommendation. The non-modifiable drug combination of bedaquiline, pretomanid, and linezolid (BPaL) may be used alternatively in selected pre-XDR-TB cases, provided that all prerequisites are met. The necessary requirements for using BPaLM and BPaL are presented in detail in this amendment to the consensus-based TB treatment guideline for adult patients.

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