The article of this week, Faster for less: the new “shorter” regimen for multidrug-resistant tuberculosis, published on the European Respiratory Journal, is suggested by professor Giovanni Battista Migliori, Chair of WAidid working group on tuberculosis.
SUMMARY: Multidrug resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are growing clinical and public health concerns, with an estimated worldwide incidence and mortality of 480 000 and 190 000 cases, respectively (2014). Presently, several of the available drugs have limited efficacy, being either toxic or unobtainable or both, and the treatment may take up to 24 months or longer. Recently, WHO published new recommendations aimed at speeding up TB second-line drug resistance detection (rapid molecular MTBDRsl test) and improving treatment outcomes of MDR-TB cases (shorter MDR-TB regimen). This is a demonstration of the efforts urgently being made to provide wider access to diagnosis and treatment in countries with the highest burden of MDR-TB. A question clinicians will ask is whether the shorter MDR-TB regimen is likely to work in all settings and especially outside trial conditions.
The article highlights the importance of drug resistances evaluation to identify candidates for the shorter regimen in MDR-TB hot spots.
AUTHORS: Sotgiu G, Tiberi S, D'Ambrosio L, Centis R, Alffenaar JW, Caminero JA, Abdo Arbex M, Alarcon Guizado V, Aleksa A, Dore S, Gaga M, Gualano G, Kunst H, Payen MC, Roby Arias AJ, Skrahina A, Solovic I, Sulis G, Tadolini M, Zumla A, Migliori GB