With the release of a “pre-final text” of updated guidelines for treatment of multidrug- and rifampicin-resistant tuberculosis, the World Health Organization made official substantial changes to its recommendations that the agency first announced in August.
The changes, announced in a “rapid communication,” which the WHO said was intended to give TB programs time to plan for new regimens, include specifying that kanamycin and capreomycin, two injected medicines that can, and in up to half of patients receiving them, do cause permanent hearing loss, are not recommended anymore. The update removes injectable medicines from recommended priority medicines for longer multidrug-resistant TB treatment regimens. South Africa’s Ministry of Health had by the time of the WHO August announcement, already announced in mid-June that it was removing the injected medicines from regimens treating multidrug resistant TB, and including bedaquiline, a medicine that received regulatory approval in 2012, but which only a small fraction of the numbers of people for whom other treatment options had failed have received.
The WHO update released today specifies that bedaquiline can be given to children aged six and older, and that the other newest TB drug, delamanid, to which access also remains limited, can be given to children from 3 years of age on.
WHO’s release of the “pre-final” text today came with an announcement that in “early 2019” consolidated guidelines for drug-resistant TB treatment will be released.