2.2 Remarks

  • The evidence review focused on the shorter regimen where the injectable agent was replaced by bedaquiline²⁶ (used for 6 months), in combination with levofloxacin/moxifloxacin, ethionamide, ethambutol, isoniazid (high-dose), pyrazinamide and clofazimine for 4 months (with the possibility of extending to 6 months if the patient remains sputum smear positive at the end of 4 months); followed by 5 months of treatment with levofloxacin/moxifloxacin, clofazimine, ethambutol and pyrazinamide.
  • After taking into account patient preference and clinical judgement, this regimen can be a preferred option for patients in whom all of the following apply: confirmed MDR/RR-TB (with at least confirmed resistance to rifampicin), with resistance to fluoroquinolones ruled out, exposure to previous treatment with second-line medicines for no more than 1 month, no extensive TB disease and no severe extrapulmonary TB (see Definitions).
  • The evidence reviewed supports the use of this regimen in patient subgroups such as people living with HIV (PLHIV) (see Section 2.4).
  • Implementation of this regimen requires access to rapid DST against fluoroquinolones.

Book navigation