Bibliographic information
GuidelineWHO consolidated guidelines on tuberculosis: module 4: treatment and care
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
WHO suggests against using 9-month DCLLfxZ or DCMZ regimen compared with currently recommended longer (>18 months) regimens in patients with fluoroquinolone-susceptible MDR/ RR-TB.
Recommended against
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).