title: Supporting clinical management of the difficult-to-treat TB cases: the ERS-WHO TB Consilium.
abstract: Multi-drug and extensively drug-resistant tuberculosis (MDR/XDR-TB) are considered a serious threat for TB control and elimination. The outcome of these patients is still largely unsatisfactory as of today, with treatment success rates being consistently below 50% at global level. The World Health Organization (WHO) recommends that management of MDR-TB cases is supported by a specialized team, including complementary medical professionals able to cover several perspectives (clinical, both for adults and children; surgical; radiological; public health; psychological; nursing, among others). Implementation of such a body (known as Consilium in most of the former Soviet Union countries) is often a pre-requisite to apply for international TB control funding and concessionally priced medicines to treat M/XDR-TB cases. The primary objective of the ERS/WHO TB Consilium is to provide clinical consultation for drug-resistant TB and other difficult-to-treat TB cases, including co-infection with HIV and paediatric cases. Through technical guidance to clinicians managing complex TB cases, the main contribution and outcome of the initiative will be a public health response aimed at achieving correct treatment of affected patients and preventing further development of drug resistance. The Consilum's secondary objective is to ensure monitoring and evaluation of clinical practices on the ground (diagnosis, treatment and prevention).
authors: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Via Roncaccio 16, 21049, Tradate, Italy. Electronic address: lia.dambrosio@fsm.it.
authors: Lia
authors: L
authors: D'Ambrosio
authors: Section of Infectious Diseases, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Massarenti 11, 40138, Bologna, Italy. Electronic address: mtadolini@hotmail.com.
authors: Marina
authors: M
authors: Tadolini
authors: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Via Roncaccio 16, 21049, Tradate, Italy. Electronic address: rosella.centis@fsm.it.
authors: Rosella
authors: R
authors: Centis
authors: Pneumologia, Centro de Diagnóstico Pneumológico, Vila Nova de Gaia, Rua Conceição Fernandes 4430 Portugal. Electronic address: raquelafduarte@gmail.com.
authors: Raquel
authors: R
authors: Duarte
authors: Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences - University of Sassari - Research, Medical Education and Professional Development Unit, AOU Sassari, via Padre Manzella, 4, 07100, Sassari, Italy. Electronic address: gsotgiu@uniss.it.
authors: Giovanni
authors: G
authors: Sotgiu
authors: Health Science Department, University of Milan Bicocca, Respiratory Unit, AO San Gerardo, Via Pergolesi 33, 20052, Monza, Italy. Electronic address: stefano.aliberti@unimib.it.
authors: Stefano
authors: S
authors: Aliberti
authors: World Health Organization, Regional Office for Europe, UN City Marmorvej 51 DK-2100 Copenhagen Ø, Denmark. Electronic address: MDD@euro.who.int.
authors: Masoud
authors: M
authors: Dara
authors: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Via Roncaccio 16, 21049, Tradate, Italy. Electronic address: giovannibattista.migliori@fsm.it.
authors: Giovanni Battista
authors: GB
authors: Migliori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D054908:Extensively Drug-Resistant Tuberculosis / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011634:Public Health; D019114:Remote Consultation; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D014944:World Health Organization; D055815:Young Adult
keywords: ERS/WHO Consilium; MDR-TB; XDR-TB; clinical management; drug resistance; prevention