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For several decades the World Health Organization (WHO) developed and issued recommendations on the treatment of TB. The most recent WHO recommendations for treating people suffering from drug-susceptible TB (DS-TB) have been defined in the WHO's Guidelines for treatment of drug-susceptible tuberculosis and patient care, 2010 and 2017 updates [3, 4]. These guidelines focused on the 6-month treatment regimen composed of four first-line TB medicines, namely isoniazid, rifampicin, ethambutol and pyrazinamide, recommended for treatment of DS-TB. This regimen is well known and has been widely adopted worldwide for decades; while using it, approximately 85% of patients will have a successful treatment outcome. This regimen is based on seminal TB treatment studies conducted by the British Medical Research Council in the second half of 20th century [5]. In addition to the recommendation on the treatment regimen, the 2010 and 2017 guideline updates included a number of recommendations on the modalities and formulations used for treatment, frequency of treatment administration, special situations and patient care during treatment. The consolidated and updated guidelines in the current Module 4: Treatment - Drug-susceptible tuberculosis treatment, brings together, without modifications, all valid and evidence-based recommendations from the 2010 and 2017 guidelines and adds a new section based on the most recent round of guidelines development - the recommendations for the 4-month treatments of DS-TB.
This module of the consolidated guidelines includes recommendations related to treatment of DS-TB in all age groups. All recommendations on patient care and support during treatment, for both the DS-TB and drug-resistant TB (DR-TB) have been merged in a dedicated module on "Tuberculosis care and support". The recommendations specific for children and adolescents are consolidated in the module on Management of tuberculosis in children and adolescents.
The update of the guidelines for treatment of DS-TB is important in the context of the End TB Strategy (1) which recommends treatment and patient support for all people with TB.