Drug-resistant tuberculosis treatment

(no
 
change)
Imipenem–cilastatin or mer
openem may be included in 
the tr
eatment o
f MDR/RR-TB patients on longer r
egimens 
(conditional r
ecommendation, ver
y low cer
tainty in the estimates 
of
 
effect).
3.10 Imipenem–cilastatin or mer
openem may be included in the tr
eatment o
f 
MDR/RR-TB patients on longer
regimens.
(Conditional r
ecommendation, ver
y low cer
tainty in the estimates o
f effect).
69
 
(no
 
change)
69
Imipenem–cilastatin and mer
openem 
ar
e administer
ed with clavulanic acid, which is available only in for
mulations combined with amo
xicillin. Amo
xicillin–clavulanic acid is not counted as an additional effective 
TB agent, and should not be used without imipenem– cilastatin or mer
openem. 

---

WHO consolidated 
guidelines 
on
tuberculosis: 
drug-resistant tuberculosis treatment
93
Recommendations in the 2019 updat
e
Recommendations in the curr
ent updat
e
Amikacin may be included in the tr
eatment o
f MDR/RR-TB 
patients aged 18 year
s or mor
e on longer r
egimens when 
susceptibility has been demonstrated and adequate measur
es to 
monitor for adver
se r
eactions can be ensur
ed. If amikacin is not 
available, str
eptomycin may r
eplace amikacin under the same 
conditions 
(conditional r
ecommendation, ver
y low cer
tainty in the 
estimates o
f
 
effect).
3.11 Amikacin may be included in the tr
eatment o
f MDR/RR-TB patients 
aged 18 year
s or mor
e on longer r
egimens when susceptibility has been 
demonstrated and adequate measur
es to monitor for adver
se r
eactions can be 
ensur
ed. If amikacin is not available, str
eptomycin may r
eplace amikacin under 
the same conditions. 
(Conditional r
ecommendation, ver
y low cer
tainty in the estimates o
f effect).