Clinical standards for drug-susceptible pulmonary TB

O. W. Akkerman, R. Duarte, S. Tiberi, H. S. Schaaf, C. Lange, J. W.C. Alffenaar, J. Denholm, A. C.C. Carvalho, M. S. Bolhuis, S. Borisov, J. Bruchfeld, A. M. Cabibbe, J. A. Caminero, I. Carvalho, J. Chakaya, R. Centis, M. P. Dalcomo, L. D'Ambrosio, M. Dedicoat, K. DhedaK. E. Dooley, J. Furin, J. M. Garcia-Garcia, N. A.H. van Hest, B. C. de Jong, X. Kurhasani, A. G. Martson, S. Mpagama, M. Munoz Torrico, E. Nunes, C. W.M. Ong, D. J. Palmero, R. Ruslami, A. M.I. Saktiawati, C. Semuto, D. R. Silva, R. Singla, I. Solovic, S. Srivastava, J. E.M. de Steenwinkel, A. Story, M. G.G. Sturkenboom, M. Tadolini, Z. F. Udwadia, A. R. Verhage, J. P. Zellweger, G. B. Migliori

Research output: Contribution to journalArticlepeer-review


BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice' for diagnosis, treatment and management of drug-susceptible pulmonary TB (PTB). METHODS : A panel of 54 global experts in the field of TB care, public health, microbiology, and pharmacology were identified; 46 participated in a Delphi process. A 5- point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all 46 participants. RESULTS : Seven clinical standards were defined: Standard 1, all patients (adult or child) who have symptoms and signs compatible with PTB should undergo investigations to reach a diagnosis; Standard 2, adequate bacteriological tests should be conducted to exclude drug-resistant TB; Standard 3, an appropriate regimen recommended by WHO and national guidelines for the treatment of PTB should be identified; Standard 4, health education and counselling should be provided for each patient starting treatment; Standard 5, treatment monitoring should be conducted to assess adherence, follow patient progress, identify and manage adverse events, and detect development of resistance; Standard 6, a recommended series of patient examinations should be performed at the end of treatment; Standard 7, necessary public health actions should be conducted for each patient. We also identified priorities for future research into PTB. CONCLUSION: These consensus-based clinical standards will help to improve patient care by guiding clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment for PTB.

Original languageEnglish (US)
Pages (from-to)592-604
Number of pages13
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number7
StatePublished - Jul 1 2022


  • clinical standards
  • diagnosis
  • education
  • management
  • pulmonary TB
  • rehabilitation
  • treatment

ASJC Scopus subject areas

  • General Medicine


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