title: Short-course treatment for multidrug-resistant tuberculosis: the STREAM trials.
abstract: Multidrug-resistant (MDR) tuberculosis (TB) is a threat to global TB control, as suboptimal and poorly tolerated treatment options have resulted in largely unfavourable outcomes for these patients. The last of six cohort studies conducted in Bangladesh which assessed a new shorter regimen using currently available TB drugs showed promising results and offered the possibility of a more acceptable and more effective regimen than the one recommended by the World Health Organization (WHO). The aims of stage 1 of the STREAM (Evaluation of a Standardised Treatment Regimen of Anti-tuberculosis Drugs for Patients with Multidrug-resistant Tuberculosis) trial are to evaluate the efficacy and safety of this regimen, compared to the current WHO-recommended standard of care. Stage 2 evaluates two new bedaquiline-containing regimens: one an all-oral regimen and the second a further shortened and simplified version of the stage 1 study regimen, comparing the efficacy and safety of each to that of the stage 1 study regimen and also to the WHO-recommended standard of care. Success of the stage 1 study regimen would in all probability provide a new standard of care for MDR-TB patients, while positive results from the bedaquiline-containing regimens in stage 2 may allow for even greater progress in the management of this difficult population.
authors.affiliation: Medical Research Council Clinical Trials Unit at University College London, Institute of Clinical Trials and Methodology, London, UK riya.moodley@ucl.ac.uk.
authors.forename: Riya
authors.initials: R
authors.lastname: Moodley
authors.affiliation: Medical Research Council Clinical Trials Unit at University College London, Institute of Clinical Trials and Methodology, London, UK A full list of the STREAM Trial Team members and their affiliations can be found in the Acknowledgements section.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Godec
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents