Drug-resistant tuberculosis treatment

18–20 months is suggested for most patients; the duration may be modified 
according to the patient’s response to
 
therapy.
(Conditional recommendation, very low certainty in the estimates of
 
effect)
3.16
In MDR/RR-TB patients on longer regimens, a treatment duration of 15–17 months 
after culture conversion is suggested for most patients; the duration may be 
modified according to the patient’s response to
 
therapy.
(Conditional recommendation, very low certainty in the estimates of
 
effect)
3.17
In MDR/RR-TB patients on longer regimens containing amikacin or streptomycin, 
an intensive phase of 6–7 months is suggested for most patients; the duration may 
be modified according to the patient’s response to
 
therapy.
(Conditional recommendation, very low certainty in the estimates of
 
effect)
3.2 Justification and evidence
This section refers to recommendations on MDR-TB treatment regimens that are of longer duration 
than the 9–12 month shorter MDR-TB regimen described in Section 2. The recommendations in this 
section address PICO questions formulated in 2018 and 2019. The questions formulated in 2018 
were as
follows:
37 
Imipenem–cilastatin and meropenem are administered with clavulanic acid, which is available only in formulations combined with 
amoxicillin. Amoxicillin–clavulanic acid is not counted as an additional effective TB agent, and should not be used without imipenem– 
cilastatin or meropenem. 

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WHO consolidated 
guidelines 
on
tuberculosis: 
drug-resistant tuberculosis treatment
23