Consolidated Guidelines

Summary of changes to the World Health Organization (WHO) treatment recommendations for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) between 2019, 2020 and the current update (in 2022).

Notes:

Further research is needed in the following areas:

1. the role of surgery – that is, decisions about when to operate, and the type of surgical intervention, and drug-resistance patterns; and
2. improved collection, reporting and standardization of data on surgery, including long-term survival post-surgery.  

No research gaps were identified.

Further research is needed in the following areas:

The GDG 2018 assessed the individual contribution to patient outcomes of medicines used in longer MDR-TB regimens, using primarily the estimates of effect from the 2018 IPD meta-analysis and Trial 213 (delamanid) for PICO question 3–2018 (MDR/RR-TB, 2018) (see Web Annex 3 for the respective GRADE summaries of evidence for each medicine, and Web Annex 4 for the evidence-to-deci

The development of the current recommendations was made possible by the availability of a global Hr-TB IPD. As in other IPD analyses conducted to inform WHO treatment guidelines in recent years, the Hr-TB IPD analysis facilitated the comparison of different patient groups, some adjustment for covariates and better interpretation of the results (57). It is important for researchers and national programmes to continue contributing patient records to the Hr-TB IPD, to increase its value as a source of information for future treatment policy.

This section refers to recommendations on MDR/RR-TB treatment regimens that are of longer duration than the regimens described in Sections 1 and 2.

PICO questions

The recommendations in this section address PICO questions formulated in 2018 and 2019. The questions formulated in 2018 were as follows:

Further research is needed in the following areas:

Further research is needed in the following areas:

Further research is needed in the following areas: