Bibliographic information
GuidelineWHO consolidated guidelines on tuberculosis: module 4: treatment and care
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
Maintained
WHO suggests using the 9-month all-oral regimens (BLMZ, BLLfxCZ and BDLLfxZ) over currently recommended longer (>18 months) regimens in patients with MDR/RR-TB and in whom resistance to fluoroquinolones has been excluded. Amongst these regimens, using BLMZ is suggested over using BLLfxCZ, and BLLfxCZ is suggested over BDLLfxZ
Recommended in favor
Conditional
Certainty of evidence
Very low
Notes and Remarks
- 1.The recommended modified 9-month all-oral regimens comprise bedaquiline, linezolid andpyrazinamide in different combinations with levofloxacin/moxifloxacin, clofazimine and delamanid.2. This recommendation applies to the following:a. People with MDR/RR-TB and in whom resistance to fluoroquinolones has been excluded.b. People with diagnosed pulmonary TB, including children, adolescents, PLHIV, and pregnantand breastfeeding women.c. People with extensive TB disease and all forms of extrapulmonary TB except for TB involvingthe CNS, osteoarticular TB or disseminated forms of TB with multiorgan involvement.d. People with MDR/RR-TB and less than 1 month of previous exposure to any of the componentmedicines of the regimen (apart from pyrazinamide and fluoroquinolones). When exposureis greater than 1 month, these patients may still receive one of the regimens if resistance tothe specific medicines with such exposure has been ruled out.e. Children and adolescents who do not have bacteriological confirmation of TB or resistancepatterns but do have a high likelihood of MDR/RR-TB (based on clinical signs and symptomsof TB, in combination with a history of contact with a patient with confirmed MDR/RR-TB).
Also Featured In
This recommendation also appears in the following guidelines:
Originally Developed
Guideline
Key updates to the treatment of drug-resistant tuberculosis: rapid communication, June 2024.
Year2024
InstitutionWorld Health Organization