Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline

Autor: Jan Brozek, Zhiyi Lan, Neha Shah, Adithya Cattamanchi, Michael Lauzardo, John W. Wilson, H. Simon Schaaf, Dick Menzies, Sundari Mase, C. Robert Horsburgh, Suzanne M. Marks, Charles L. Daley, Fayez Kheir, Graham H. Bothamley, Joan M. Mangan, Diana M. Nilsen, Terence Chorba, Payam Nahid, Faiz Ahmad Khan, Ann Raftery, Raquel Duarte, Alfred Lardizabal, Barbara Seaworth, Tracy Dalton, Charles A. Peloquin, Farah Parvez, Lisa Chen, J. Peter Cegielski, Carole D. Mitnick, Federica Fregonese, Jeffrey R. Starke, Jonathan M. Wortham, Giovanni Battista Migliori, Giovanni Sotgiu, Lindsay McKenna
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Tuberculosis
Population
Respiratory System
MEDLINE
Antitubercular Agents
MDR-TB
Critical Care and Intensive Care Medicine
Medical and Health Sciences
Drug Administration Schedule
Vaccine Related
Rare Diseases
Drug Therapy
Biodefense
medicine
Humans
Intensive care medicine
education
Lung
American Thoracic Society Documents
education.field_of_study
business.industry
Prevention
Evaluation of treatments and therapeutic interventions
drug treatment
Guideline
Pulmonary
Multidrug-Resistant
medicine.disease
Regimen
treatment monitoring
Systematic review
Emerging Infectious Diseases
Infectious Diseases
tuberculosis
6.1 Pharmaceuticals
Propensity score matching
Combination
Observational study
Antimicrobial Resistance
business
Infection
duration of treatment
Zdroj: American Journal of Respiratory and Critical Care Medicine
American journal of respiratory and critical care medicine, vol 200, iss 10
ISSN: 1535-4970
1073-449X
Popis: Background: The American Thoracic Society, U.S. Centers for Disease Control and Prevention, European Respiratory Society, and Infectious Diseases Society of America jointly sponsored this new practice guideline on the treatment of drug-resistant tuberculosis (DR-TB). The document includes recommendations on the treatment of multidrug-resistant TB (MDR-TB) as well as isoniazid-resistant but rifampin-susceptible TB. Methods: Published systematic reviews, meta-analyses, and a new individual patient data meta-analysis from 12,030 patients, in 50 studies, across 25 countries with confirmed pulmonary rifampin-resistant TB were used for this guideline. Meta-analytic approaches included propensity score matching to reduce confounding. Each recommendation was discussed by an expert committee, screened for conflicts of interest, according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Twenty-one Population, Intervention, Comparator, and Outcomes questions were addressed, generating 25 GRADE-based recommendations. Certainty in the evidence was judged to be very low, because the data came from observational studies with significant loss to follow-up and imbalance in background regimens between comparator groups. Good practices in the management of MDR-TB are described. On the basis of the evidence review, a clinical strategy tool for building a treatment regimen for MDR-TB is also provided. Conclusions: New recommendations are made for the choice and number of drugs in a regimen, the duration of intensive and continuation phases, and the role of injectable drugs for MDR-TB. On the basis of these recommendations, an effective all-oral regimen for MDR-TB can be assembled. Recommendations are also provided on the role of surgery in treatment of MDR-TB and for treatment of contacts exposed to MDR-TB and treatment of isoniazid-resistant TB.
Databáze: OpenAIRE
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