Treatment Guidelines
Tuberculosis (TB) Treatment Guideline Updates
The new tuberculosis (TB) treatment guidelines recommend a novel 4-month regimen for people with pulmonary TB and a shortened 4-month regimen for children with nonsevere TB. For drug-resistant TB, the updated regimens include bedaquiline, pretomanid, and linezolid, with or without moxifloxacin. These recommendations emphasize the use of all-oral, shorter treatment regimens for eligible individuals.
WHO Updates Drug-Resistant TB Treatment Guidelines
The World Health Organization (WHO) has released an update to the Consolidated Guidelines on Tuberculosis (TB) - Module 4: Treatment and Care, with multiple novel 6- to 9-month regimens for multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB), which can be considered if there are barriers to use of the BPaLM regimen introduced in the last update.
Key Updates
- New 6-Month Regimen: An all-oral, 6-month regimen composed of bedaquiline, delamanid, linezolid, levofloxacin and clofazimine (BDLLfxC) for treating MDR/RR-TB, including cases with additional resistance to fluoroquinolones (pre-XDR-TB).
- Modified 9-Month Regimens: Several potential 9-month regimens including bedaquiline, linezolid, moxifloxacin and pyrazinamide (BLMZ) are suggested as options for patients who are ineligible or who lack access to the 6-month regimens.
- New Two 4-month Regimens: A new regimen for the treatment of drug-susceptible tuberculosis (DS-TB), marking a significant advancement in TB care. This update formally includes two 4-month regimens for the treatment of drug-susceptible tuberculosis (DS-TB), marking a pivotal advancement in TB care.
This chapter incorporates recommendations that were made in 2022, based on new evidence that was available to WHO on the following: the use of the bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM) regimen for patients with MDR/RR-TB, and the use of 9-month all-oral bedaquiline-containing regimens for patients with MDR/RR-TB. It also includes new recommendations developed in June 2024 based on new evidence from the BEAT Tuberculosis (BEAT-TB) and endTB trials.