TY - JOUR
T1 - Alignment of new tuberculosis drug regimens and drug susceptibility testing
T2 - A framework for action
AU - Wells, William A.
AU - Boehme, Catharina C.
AU - Cobelens, Frank G.J.
AU - Daniels, Colleen
AU - Dowdy, David
AU - Gardiner, Elizabeth
AU - Gheuens, Jan
AU - Kim, Peter
AU - Kimerling, Michael E.
AU - Kreiswirth, Barry
AU - Lienhardt, Christian
AU - Mdluli, Khisi
AU - Pai, Madhukar
AU - Perkins, Mark D.
AU - Peter, Trevor
AU - Zignol, Matteo
AU - Zumla, Alimuddin
AU - Schito, Marco
N1 - Funding Information:
This project has been funded in part with federal funds from the National Institute of Allergies and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract number HHSN272200800014C. TB Alliance is funded by the Bill & Melinda Gates Foundation, European Commission, Irish Aid, National Institute of Allergy and Infectious Diseases, UK Department for International Development, UNITAID, US Agency for International Development, and the US Food and Drug Administration. The opinions expressed herein are those of the authors and do not reflect the official policies of the US Department of Health and Human Services or the authors' national governments, nor does mention of trade names, commercial practices, or organisations imply endorsement by the US Government or the authors' national governments.
PY - 2013/5
Y1 - 2013/5
N2 - 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.
AB - 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.
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U2 - 10.1016/S1473-3099(13)70025-2
DO - 10.1016/S1473-3099(13)70025-2
M3 - Review article
C2 - 23531393
AN - SCOPUS:84876697735
SN - 1473-3099
VL - 13
SP - 449
EP - 458
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 5
ER -