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, I Carvalho, J Chakaya, R Centis, M P Dalcomo, L D'Ambrosio, M Dedicoat, K DhedaK E Dooley, J Furin, J-M García-García, N A H van Hest, B C de Jong, X Kurhasani, A G Märtson, S Mpagama, M Munoz Torrico, E Nunes, C W M Ong, D J Palmero, R Ruslami, A M I Saktiawati, C Semuto, D R Silva, R Singla, I 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

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Samenvatting

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 5-point 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.

Originele taal-2English
Pagina's (van-tot)592-604
Aantal pagina's13
TijdschriftInternational Journal of Tuberculosis and Lung Disease
Volume26
Nummer van het tijdschrift7
DOI's
StatusPublished - 1-jul-2022

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