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Over the past few decades, treatment of multidrug-resistant (MDR)/extensively drug-resistant (XDR) tuberculosis (TB) has been challenging because of its prolonged duration (up to 20-24 months), toxicity, costs and sub-optimal outcomes.After over 40 years of neglect, two new drugs (bedaquiline and delamanid) have been made available to manage difficult-to-treat MDR-/XDR-TB cases. World Health Organization (WHO) guidelines published in March 2019 endorsed the possibility of treating MDR-TB patients with a full oral regimen, following previous guidelines published in 2016 which launched a shorter regimen lasting 9-10 months.The objectives of this article are to review the main achievements in MDR-TB treatment through the description of the existing WHO strategies, to discuss the main ongoing trials and to shed light on potential future scenarios and revised definitions necessary to manage drug-resistant TB.

Original publication

DOI

10.1183/16000617.0035-2019

Type

Journal article

Journal

European respiratory review : an official journal of the European Respiratory Society

Publication Date

06/2019

Volume

28

Addresses

Dept of Infectious Diseases, Galliera Hospital, Genova, Italy.

Keywords

and the writing group members of the Global TB Network Clinical Trials Committee, Humans, Tuberculosis, Multidrug-Resistant, Antitubercular Agents, Treatment Outcome, Drug Therapy, Combination, Drug Administration Schedule, Drug Resistance, Multiple, Bacterial, Forecasting, History, 20th Century, History, 21st Century, Diffusion of Innovation, Extensively Drug-Resistant Tuberculosis