Clinical standards for antimicrobial stewardship in TB care

Background: While antimicrobial stewardship (AMS) is essential for combating antimicrobial resistance (AMR), TB-specific AMS strategies remain poorly defined. Methods: An international panel of 62 experts participated in a Delphi process. Using a 5-point Likert scale (5 = strong agreement; 1 = strong disagreement), participants evaluated 10 draft clinical standards developed by a core coordination team. A standard was adopted if ≥90% of respondents rated it three or higher, according to a predefined consensus threshold. Results: All 10 standards reached the consensus threshold and were adopted: Standard 1, integration of TB into national AMR action plans; Standard 2, implementation of TB surveillance systems; Standard 3, education of health care providers, individuals affected by TB, and the public; Standard 4, integration of TB into AMS activities; Standard 5, establishment of expert consultation services; Standard 6, targeted testing and preventive treatment for individuals at risk for TB; Standard 7, access to timely and comprehensive drug susceptibility testing; Standard 8, prioritisation of efficacy, safety, and resistance prevention in TB treatment regimens; Standard 9, clinical and microbiological monitoring of treatment response; and Standard 10, assessment of adherence, drug exposure, and resistance in treatment failure. Conclusion: These clinical standards aim to support clinicians, programme managers, and public health authorities in implementing effective, TB-specific AMS strategies.

Palavras-chave

Tuberculosis Antimicrobial Resistance Drug Resistance Rifampicin Resistance Infecções Respiratórias Resistência aos Antimicrobianos

URI

http://hdl.handle.net/10400.18/10920

Citação

IJTLD Open. 2025 Dec 10;2(12):716-726. doi: 10.5588/ijtldopen.25.0522. eCollection 2025 Dec

Editora

International Union Against Tuberculosis and Lung Disease

DOI

10.5588/ijtldopen.25.0522

Coleções

CD - Artigos em revistas internacionais
INSA - Artigos em revistas internacionais

Licença CC

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