title: Management of multidrug-resistant TB: novel treatments and their expansion to low resource settings.
abstract: Despite overall progress in global TB control, the rising burden of multidrug-resistant TB (MDR-TB) threatens to undermine efforts to end the worldwide epidemic. Of the 27 countries classified as high burden for MDR-TB, 17 are in 'low' or 'low-middle' income countries. Shorter, all oral and less toxic multidrug combinations are required to improve treatment outcomes in these settings. Suitability for safe co-administration with HIV drugs is also desirable. A range of strategies and several new drugs (including bedaquiline, delamanid and linezolid) are currently undergoing advanced clinical evaluations to define their roles in achieving these aims. However, several clinical questions and logistical challenges need to be overcome before these new MDR-TB treatments fulfil their potential.
authors.affiliation: Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK derek.sloan@lstmed.ac.uk.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Sloan
authors.affiliation: Wellcome Trust Liverpool Glasgow Centre for Global Health Research, University of Liverpool L69 3GF, UK Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Lewis
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D003906:Developing Countries; D019468:Disease Management; D004359:Drug Therapy, Combination; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014944:World Health Organization
chemical_list: D000995:Antitubercular Agents
keywords: Bedaquiline; Delamanid; Extensively drug-resistant; Linezolid; Multidrug-resistant; Tuberculosis