title: Alignment of new tuberculosis drug regimens and drug susceptibility testing: a framework for action.
abstract: New tuberculosis drug regimens are creating new priorities for drug susceptibility testing (DST) and surveillance. To minimise turnaround time, rapid DST will need to be prioritised, but developers of these assays will need better data about the molecular mechanisms of resistance. Efforts are underway to link mutations with drug resistance and to develop strain collections to enable assessment of new diagnostic assays. In resource-limited settings, DST might not be appropriate for all patients with tuberculosis. Surveillance data and modelling will help country stakeholders to design appropriate DST algorithms and to decide whether to change drug regimens. Finally, development of practical DST assays is needed so that, in countries where surveillance and modelling show that DST is advisable, these assays can be used to guide clinical decisions for individual patients. If combined judiciously during both development and implementation, new tuberculosis regimens and new DST assays have enormous potential to improve patient outcomes and reduce the burden of disease.
authors.affiliation: Global Alliance for TB Drug Development, New York, NY, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Wells
authors.forename: Catharina C
authors.initials: CC
authors.lastname: Boehme
authors.forename: Frank G J
authors.initials: FG
authors.lastname: Cobelens
authors.forename: Colleen
authors.initials: C
authors.lastname: Daniels
authors.forename: David
authors.initials: D
authors.lastname: Dowdy
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gardiner
authors.forename: Jan
authors.initials: J
authors.lastname: Gheuens
authors.forename: Peter
authors.initials: P
authors.lastname: Kim
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kimerling
authors.forename: Barry
authors.initials: B
authors.lastname: Kreiswirth
authors.forename: Christian
authors.initials: C
authors.lastname: Lienhardt
authors.forename: Khisi
authors.initials: K
authors.lastname: Mdluli
authors.forename: Madhukar
authors.initials: M
authors.lastname: Pai
authors.forename: Mark D
authors.initials: MD
authors.lastname: Perkins
authors.forename: Trevor
authors.initials: T
authors.lastname: Peter
authors.forename: Matteo
authors.initials: M
authors.lastname: Zignol
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.forename: Marco
authors.initials: M
authors.lastname: Schito
mesh_terms: D000465:Algorithms; D000995:Antitubercular Agents / Q000008:administration & dosage*; D016208:Databases, Factual; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000472:pathogenicity; D011159:Population Surveillance; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents