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

Publication

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

Journal Paper/Review - May 29, 2024

Otto-Knapp Ralf, Bauer Torsten, Brinkmann Folke, Feiterna-Sperling Cornelia, Friesen Inna, Geerdes-Fenge Hilte, Hartmann Pia, Häcker Brit, Heyckendorf Jan, Kuhns Martin, Lange Christoph, Maurer Florian P, Nienhaus Albert, Priwitzer Martin, Richter Elvira, Salzer Helmut J F, Schoch Otto, Schönfeld Nicolas, Schaberg Tom

Citation

Otto-Knapp R, Bauer T, Brinkmann F, Feiterna-Sperling C, Friesen I, Geerdes-Fenge H, Hartmann P, Häcker B, Heyckendorf J, Kuhns M, Lange C, Maurer F, Nienhaus A, Priwitzer M, Richter E, Salzer H, Schoch O, Schönfeld N, Schaberg T. Treatment of MDR, Pre-XDR, XDR, and Rifampicin-Resistant Tuberculosis or in Case of Intolerance to at Least Rifampicin in Austria, Germany, and Switzerland. Respiration 2024; 103:593-600.

Type

Journal Paper/Review (English)

Journal

Respiration 2024; 103

Publication Date

May 29, 2024

Issn Electronic

1423-0356

Pages

593-600

Brief description/objective

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.