Guidelines for treatment of drug-susceptible tuberculosis and patient care (2017 update)

The update of the Guidelines for treatment of drug-susceptible tuberculosis and patient care is important in the context of the End TB Strategy, which recommends treatment and patient support for all people with TB. This update by WHO aims to use the best available evidence on the treatment of drug-susceptible TB and interventions to ensure adequate patient care and support in order to inform policy decisions made in these technical areas by national TB control programme managers, national policy-makers and medical practitioners in a variety of geographical, economic and social settings.

The objectives of the updated Guidelines for treatment of drug-susceptible tuberculosis and patient care are:

1) to provide updated recommendations based on newly emerged evidence on the treatment of drug-susceptible TB and patient care; and

2) to provide a summary of changes in the new guidelines together with all the existing and valid WHO recommendations on the treatment of drug-susceptible TB and TB patient care.

The main highlights of the guidelines are:

• The category II regimen is no longer recommended for patients who require TB retreatment and drug-susceptibility testing should be conducted to inform the choice of treatment regimen;
• The use of adjuvant steroids is recommended in the treatment of tuberculous meningitis and pericarditis;
• Recommendations on the provision of individual or a package of interventions on patient care and support, including patient or staff education, material support, psychological support, and tracers;
• Recommendations on the use of digital health interventions such as SM or phone call as an tracer option), medication monitor, and video observed treatment (VOT – as a replacement for in-person directly observed treatment - DOT) when conditions of technology and operation allow;
• Recommendations on the effective treatment administration options: community or home-based DOT, and DOT administered by trained lay providers or health-care workers; and
• Decentralized model of care is recommended over centralized model for patients on MDR-TB treatmen

 The article is available here.