Clinical standards for drug-susceptible pulmonary TB

O. W. Akkerman, R. Duarte, S. Tiberi, H. S. Schaaf, C. Lange, J. W. C. Alffenaar, J. Denholm, A. C. C. Carvalho, M. S. Bolhuis, S. Borisov, J. Bruchfeld, A. M. Cabibbe, J. A. Caminero, MRC Carvalho, J. Chakaya, R. Centis, M. P. Dalcomo, L. D. Ambrosio, M. Dedicoat, K. DhedaK. E. Dooley, J. Furin, J-M Garcia-Garcia, N. A. H. van Hest, B. C. de Jong, X. Kurhasani, A. G. Martson, S. Mpagama, M. Munoz Torrico, E. Nunes, C. W. M. Ong, D. J. Palmero, R. Ruslami, A. M. Saktiawati, C. Semuto, D. R. Silva, R. Singla, Solovic, S. Srivastava, J. E. M. de Steenwinkel, A. Story, M. G. G. Sturkenboom, M. Tadolini, Z. F. Udwadia, A. R. Verhage, J. P. Zellweger, G. B. Migliori

Research output: Contribution to journalA1: Web of Science-articlepeer-review

Abstract

BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice' for diagnosis, treatment and management of drug-susceptible pulmonary TB (PTB).

METHODS: A panel of 54 global experts in the field of TB care, public health, microbiology, and pharmacology were identified; 46 participated in a Delphi process. A 5point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all 46 participants.

RESULTS: Seven clinical standards were defined: Standard 1, all patients (adult or child) who have symptoms and signs compatible with PTB should undergo investigations to reach a diagnosis; Standard 2, adequate bacteriological tests should be conducted to exclude drug-resistant TB; Standard 3, an appropriate regimen recommended by WHO and national guidelines for the treatment of PTB should be identified; Standard 4, health education and counselling should be provided for each patient starting treatment; Standard 5, treatment monitoring should be conducted to assess adherence, follow patient progress, identify and manage adverse events, and detect development of resistance; Standard 6, a recommended series of patient examinations should be performed at the end of treatment; Standard 7, necessary public health actions should be conducted for each patient. We also identified priorities for future research into PTB.

CONCLUSION: These consensus-based clinical standards will help to improve patient care by guiding clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment for PTB.

Original languageEnglish
JournalInternational Journal of Tuberculosis and Lung Disease
Volume26
Issue number7
Pages (from-to)592-604
Number of pages13
ISSN1027-3719
DOIs
Publication statusPublished - 2022

Keywords

  • pulmonary TB
  • management
  • diagnosis
  • treatment
  • education
  • rehabilitation
  • clinical standards
  • MULTIDRUG-RESISTANT TUBERCULOSIS
  • PREVENTION/INFECTIOUS DISEASES SOCIETY
  • AMERICAN THORACIC SOCIETY/CENTERS
  • PRACTICE GUIDELINES TREATMENT
  • MYCOBACTERIUM-TUBERCULOSIS
  • TREATMENT OUTCOMES
  • SPUTUM COLLECTION
  • END TB
  • MANAGEMENT
  • ADHERENCE

Cite this