Alignment of new tuberculosis drug regimens and drug susceptibility testing: A framework for action

William A. Wells, Catharina C. Boehme, Frank G.J. Cobelens, Colleen Daniels, David Dowdy, Elizabeth Gardiner, Jan Gheuens, Peter Kim, Michael E. Kimerling, Barry Kreiswirth, Christian Lienhardt, Khisi Mdluli, Madhukar Pai, Mark D. Perkins, Trevor Peter, Matteo Zignol, Alimuddin Zumla, Marco Schito

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)449-458
Number of pages10
JournalThe Lancet Infectious Diseases
Volume13
Issue number5
DOIs
StatePublished - May 2013

ASJC Scopus subject areas

  • Infectious Diseases

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