The WHO treatment guidelines for drug-resistant tuberculosis (2016 update) contains policy recommendations on priority areas in the treatment of drug-resistant tuberculosis. The revision is in accordance with the WHO requirements for the formulation of evidence-informed policy.

The main novelties of the 2016 WHO guidelines are:

• a shorter MDR-TB treatment regimen is recommended under specific conditions;
• medicines used in the design of conventional MDR-TB treatment regimens are now reclassified to reflect updates in the evidence on their effectiveness and safety;
• specific recommendations are made on the treatment of children with rifampicin-resistant or MDR-TB based on a first-ever individual patient data meta-analysis;
• recommendations on the role of surgery in MDR-TB case management are included.

Contents

• Abbreviations & acronyms
• Acknowledgements
• Declarations of interest
• Executive summary
• Introduction
• Methods
  • Preparation for revision
  • Scope
  • Key questions
  • Certainty of evidence and strength of recommendations
  • Definitions
  • Assessment of evidence and its grading
  • External review
  • Publication, implementation, evaluation and expiry
• WHO policy recommendations
  • A The effectiveness and safety of standardized regimens lasting up to 12 months for the treatment of patients with MDR-TB when compared with longer treatment
  • B The optimal combination of medicines and approach towards regimen design for TB patients with RR-TB and MDR-TB
  • C The effect of delay in starting treatment on treatment outcomes for patients with drug-resistant TB
  • D The effect of surgical interventions on treatment outcomes for patients with drug-resistant TB
  • E Research priorities
• References
• Appendix 1 Agenda for the Guidelines Development Group meeting on the WHO treatment guidelines for drug-resistant TB 2016 update, 9–11 November 2015
• Appendix 2 Experts involved in the development of the WHO treatment guidelines for drug-resistant TB 2016 update
• Appendix 3 PICO questions
• Appendix 4 GRADE tables
• Appendix 5 Evidence to decision tables
• Appendix 6 Summaries of unpublished data used for the recommendations

These guidelines were developed in compliance with the process for evidence gathering, assessment and formulation of recommendations, as outlined in the WHO Handbook for Guideline Development (version March 2014; available at http://www​.who.int/kms/handbook_2nd_ed​.pdf ).

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