Operational considerations of select new treatment recommendations for drug-susceptible and drug-resistant tuberculosis

A number of management updates recently have been published for both drug-susceptible and drug-resistant tuberculosis (TB), TB in children, and contacts of patients with drug-resistant TB. The operationalization and application of these recommendations, which reflect favorable clinical trial outcomes, may vary significantly for different patient groups and in different settings. Defining the best treatment approach for each patient requires the integration of multiple data points including organism culture growth and corresponding drug susceptibility profiles, specific TB syndrome, concurrent patient co-morbidities and available public health resources. We review several updated TB treatment recommendations and discuss applicable strengths, select limitations and corresponding precautions as they pertain to diverging patient groups, TB syndromes, and public health capacity.