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. Dheda; K. 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; null 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

doi:10.5588/ijtld.22.0228

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

Mycobacteriology

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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 language	English
Journal	International Journal of Tuberculosis and Lung Disease
Volume	26
Issue number	7
Pages (from-to)	592-604
Number of pages	13
ISSN	1027-3719
DOIs	https://doi.org/10.5588/ijtld.22.0228
Publication status	Published - 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

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10.5588/ijtld.22.0228Licence: CC BY

2022ijtl0592Final published version, 145 KBLicence: CC BY

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Akkerman, O. W., Duarte, R., Tiberi, S., Schaaf, H. S., Lange, C., Alffenaar, J. W. C., Denholm, J., Carvalho, A. C. C., Bolhuis, M. S., Borisov, S., Bruchfeld, J., Cabibbe, A. M., Caminero, J. A., Carvalho, MRC., Chakaya, J., Centis, R., Dalcomo, M. P., Ambrosio, L. D., Dedicoat, M., ... Migliori, G. B. (2022). Clinical standards for drug-susceptible pulmonary TB. International Journal of Tuberculosis and Lung Disease, 26(7), 592-604. https://doi.org/10.5588/ijtld.22.0228

@article{fae9b1ccf53c4110a251caa30ece1787,

title = "Clinical standards for drug-susceptible pulmonary TB",

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.",

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",

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

note = "FTX; (CC BY 4.0)",

year = "2022",

doi = "10.5588/ijtld.22.0228",

language = "English",

volume = "26",

pages = "592--604",

journal = "International Journal of Tuberculosis and Lung Disease",

issn = "1027-3719",

publisher = "International Union Against Tuberculosis and Lung Disease",

number = "7",

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Akkerman, OW, Duarte, R, Tiberi, S, Schaaf, HS, Lange, C, Alffenaar, JWC, Denholm, J, Carvalho, ACC, Bolhuis, MS, Borisov, S, Bruchfeld, J, Cabibbe, AM, Caminero, JA, Carvalho, MRC, Chakaya, J, Centis, R, Dalcomo, MP, Ambrosio, LD, Dedicoat, M, Dheda, K, Dooley, KE, Furin, J, Garcia-Garcia, J-M, van Hest, NAH, de Jong, BC, Kurhasani, X, Martson, AG, Mpagama, S, Torrico, MM, Nunes, E, Ong, CWM, Palmero, DJ, Ruslami, R, Saktiawati, AM, Semuto, C, Silva, DR, Singla, R, Solovic, Srivastava, S, de Steenwinkel, JEM, Story, A, Sturkenboom, MGG, Tadolini, M, Udwadia, ZF, Verhage, AR, Zellweger, JP & Migliori, GB 2022, 'Clinical standards for drug-susceptible pulmonary TB', International Journal of Tuberculosis and Lung Disease, vol. 26, no. 7, pp. 592-604. https://doi.org/10.5588/ijtld.22.0228

TY - JOUR

T1 - Clinical standards for drug-susceptible pulmonary TB

AU - Akkerman, O. W.

AU - Duarte, R.

AU - Tiberi, S.

AU - Schaaf, H. S.

AU - Lange, C.

AU - Alffenaar, J. W. C.

AU - Denholm, J.

AU - Carvalho, A. C. C.

AU - Bolhuis, M. S.

AU - Borisov, S.

AU - Bruchfeld, J.

AU - Cabibbe, A. M.

AU - Caminero, J. A.

AU - Carvalho, MRC

AU - Chakaya, J.

AU - Centis, R.

AU - Dalcomo, M. P.

AU - Ambrosio, L. D.

AU - Dedicoat, M.

AU - Dheda, K.

AU - Dooley, K. E.

AU - Furin, J.

AU - Garcia-Garcia, J-M

AU - van Hest, N. A. H.

AU - de Jong, B. C.

AU - Kurhasani, X.

AU - Martson, A. G.

AU - Mpagama, S.

AU - Torrico, M. Munoz

AU - Nunes, E.

AU - Ong, C. W. M.

AU - Palmero, D. J.

AU - Ruslami, R.

AU - Saktiawati, A. M.

AU - Semuto, C.

AU - Silva, D. R.

AU - Singla, R.

AU - Solovic, null

AU - Srivastava, S.

AU - de Steenwinkel, J. E. M.

AU - Story, A.

AU - Sturkenboom, M. G. G.

AU - Tadolini, M.

AU - Udwadia, Z. F.

AU - Verhage, A. R.

AU - Zellweger, J. P.

AU - Migliori, G. B.

N1 - FTX; (CC BY 4.0)

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

KW - pulmonary TB

KW - management

KW - diagnosis

KW - treatment

KW - education

KW - rehabilitation

KW - clinical standards

KW - MULTIDRUG-RESISTANT TUBERCULOSIS

KW - PREVENTION/INFECTIOUS DISEASES SOCIETY

KW - AMERICAN THORACIC SOCIETY/CENTERS

KW - PRACTICE GUIDELINES TREATMENT

KW - MYCOBACTERIUM-TUBERCULOSIS

KW - TREATMENT OUTCOMES

KW - SPUTUM COLLECTION

KW - END TB

KW - MANAGEMENT

KW - ADHERENCE

U2 - 10.5588/ijtld.22.0228

DO - 10.5588/ijtld.22.0228

M3 - A1: Web of Science-article

SN - 1027-3719

VL - 26

SP - 592

EP - 604

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

IS - 7

ER -

Clinical standards for drug-susceptible pulmonary TB

Abstract

Keywords

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