Clinical standards for antimicrobial stewardship in TB care

作者：T.T. Brehm, Onno W. Akkerman, Giovanni Sotgiu, Simon Tiberi, Kwok Chiu Chang, Keertan Dheda, Raquel Duarte, Debrah Vambe, Zarir Udwadia, Dumitru Chesov, Marc Mendelson, Antonia Morita Iswari Saktiawati, Jakko van Ingen, Füsun Öner Eyüboğlu, Thomas Tängdén, Luan Nguyen Quang Vo, Niccolò Riccardi, Charalampos Moschos, Jon S. Friedland, Troels Lillebæk, Sujith J Chandy, José A. Caminero, Guy Thwaites, Sumanth Gandra, Karin Thursky, Indu Anna George, Olha Konstantynovska, Razia Fatima, Jae‐Joon Yim, Nakwon Kwak, Ioana D. Olaru, Stephen H. Gillespie, Yousra Kherabi, Sivan Perl, Erlend Grønningen, C Rodrigues, Stephanie Bjerrum, F C Bange, Victoria Cox, Daniela María Cirillo, Francesca Saluzzo, Gabriel Levy Hara, Dirk Wagner, Nazir Ismail, Derek J. Sloan, I. Eshun-Wilsonova, Mei Zeng, Chloé Cantero, Tuija Vasankari, Anna M. Mandalakas, Alexander Kay, Tara Ness, M. Munoz Torrico, Gunar Günther, Līga Kukša, Lorenzo Guglielmetti, Alberto L. García‐Basteiro, Guy B. Marks, C. Pulcini, C. C. Lange · 发表于：IJTLD OPEN · 年份：2025 · DOI：10.5588/ijtldopen.25.0522 · 被引用次数：3 · 研究领域：Antibiotic Use and Resistance、Tuberculosis Research and Epidemiology、Nosocomial Infections in ICU

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-spec...