New consensus statements have been developed to help tackle the growing threat of multidrug-resistant tuberculosis (TB) and extensively drug-resistant tuberculosis (TB).
Published online today (24 March 2014) in the European Respiratory Journal¸ the statements mark the first time that physicians who treat patients with multidrug- and extensively drug-resistant TB have reached a consensus on important areas of patient management where scientific evidence is inconclusive.
The World Health Organization (WHO) estimates that currently 450,000 new cases with MDR-TB occur each year. The majority of affected patients live in the WHO European Region.
As the emergence of these forms of the disease is fairly recent, clinical evidence is lacking and could be for many years to come. To help bridge this gap in knowledge, experts from the European-based TBNET network have provided harmonised answers to the key questions for the prevention, diagnosis, treatment and management of multidrug- and extensively drug-resistant TB.
Although some guidelines are available for the treatment of people with multidrug- and extensively drug-resistant TB, this is the first time that a large group of predominantly clinical experts have joined together to provide a consensus on the management of these conditions in Europe.
The consensus statements also include useful checklists with information on which examinations should be performed during the course of the treatment and what is necessary before discharging a patient from the hospital. The authors suggest that the document can be used as a point of reference for physicians across the continent.
Lead author, Professor Christoph Lange, Head of the Respiratory Infections Assembly at the European Respiratory Society, said: "These consensus statements provide very valuable support for physicians treating patients with these deadly conditions in all parts of Europe. The current management of patients with multidrug- and extensively drug-resistant TB is complex, very costly for healthcare systems and burdensome for those who are affected.
"We have harmonised individual expert opinions on the management of multidrug- and extensively drug-resistant TB in adults and children to ensure that consensus is available where clinical evidence is still lacking. As clinicians we hope to improve the treatment of multidrug- and extensively drug-resistant TB and the life of our patients who suffer from these difficult-to-treat conditions."
- C. Lange, I. Abubakar, J.-W. C. Alffenaar, G. Bothamley, J. A. Caminero, A. C. C. Carvalho, K.-C. Chang, L. Codecasa, A. Correia, V. Crudu, P. Davies, M. Dedicoat, F. Drobniewski, R. Duarte, C. Ehlers, C. Erkens, D. Goletti, G. Gunther, E. Ibraim, B. Kampmann, L. Kuksa, W. de Lange, F. van Leth, J. van Lunzen, A. Matteelli, D. Menzies, I. Monedero, E. Richter, S. Rusch-Gerdes, A. Sandgren, A. Scardigli, A. Skrahina, E. Tortoli, G. Volchenkov, D. Wagner, M. J. van der Werf, B. Williams, W.-W. Yew, J.-P. Zellweger, D. M. Cirillo. Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement. European Respiratory Journal, 2014; DOI: 10.1183/09031936.00188313
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