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

Geneva ¦ 28 April 2017 - The World Health Organization (WHO) released today updated guidelines for the treatment of drug-susceptible tuberculosis (TB) and patient care. The guidelines feature recommendations on important developments in treatment and care which have occurred in the past seven years, since the publication of the previous guidelines.

“These guidelines are critical to support countries in the provision of quality care for people with TB, and in the implementation of the End TB Strategy”, said Dr Mario Raviglione, Director, WHO Global TB Programme. “The new recommendations make it clear that TB treatment must be patient-centric, and also take advantage of digital technologies to support care”.

Target audience

These guidelines are mainly designed for policy-makers in ministries of health or managers of national TB programmes who formulate country-specific TB treatment guidelines or who plan TB treatment programmes. In addition, all health professionals – including doctors, nurses and educators working both in government services and in nongovernmental organizations, such as technical agencies that are treating patients and organizing treatment services – are expected to use these guidelines.

Key highlights

The main updates/ highlights recommended in the guidelines include:

• The category II regimen is no longer recommended and drug-susceptibility testing should be conducted to inform the choice of the treatment regimen for patients who require TB re-treatment.
• The use of adjuvant steroids is recommended in the treatment of tuberculous meningitis and pericarditis.
• Provision of individual interventions – or a package of interventions – on patient care and support for all patients including those with drug-resistant TB. This covers patient and staff education, as well as material and psychological support.
• The use of digital health technology such as SMSes or phone calls (as a tracer option), medication monitors, and video observed treatment – as a replacement for in-person directly observed treatment – when conditions of technology and operation allow.
• Effective treatment administration options such as community or home-based treatment, over facility-based treatment.
• A decentralized model of care over a centralized model for patients on multidrug-resistant TB treatment.

“This update by WHO will greatly help inform decision-making  on the ground by national TB programme managers, national policy-makers and medical practitioners in a variety of geographical, economic and social settings", said Dr Malgosia Grzemska, Coordinator, Technical, Support, Coordination Unit at the WHO Global TB Programme. “We hope that this guidance will serve as a one-stop shop to provide evidence-based information on the treatment of drug-susceptible TB and interventions to ensure adequate patient care and support for patients with all forms of TB.”
 
A framework consolidating all guidelines on prevention, diagnosis and care of TB and drug-resistant TB are planned for release later this year.

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

Source: WHO