Updated Recommendation
A new evidence synthesis was published:2019, WHO consolidated guidelines on drug-resistant tuberculosis treatment
View latest version (2019)Bibliographic Info
Recommendation
Recommended in favor
Conditional
Certainty of evidence
Very low
In patients with isoniazid-resistant, rifampicin-resistant TB or multidrug-resistant TB , a regimen with at least five effective TB medicines during the intensive phase is recommended, including pyrazinamide and four core second-line TB medicines – one chosen from Group A, one from Group B, and at least two from Group C. If the minimum number of effective TB medicines cannot be composed as given above, an agent from Group D2 and other agents from Group D3 may be added to bring the total to five.. Group A=levofloxacin, moxifloxacin, gatifloxacin; Group B=amikacin, capreomycin, kanamycin, (streptomycin); Group C= ethionamide (or prothionamide), cycloserine (or terizidone), linezolid, clofazimine; in children with nonsevere disease Group B medicines may be excluded. Group D2=bedaquiline, delamanid; Group D3=p-aminosalicylic acid, imipenem–cilastatin, meropenem, amoxicillin clavulanate, (thioacetazone). Bedaquiline is only recommended for adults; delamanid may also be used in patients aged 6–17 years.