Clinical standards for antimicrobial stewardship in TB care

Brehm, Thomas Theo and Akkerman, Onno W. and Sotgiu, Giovanni and Tiberi, Simon and Chang, Kwokchiu and Dheda, Keertan and Duarte, R. and Vambe, Debrah and Udwadia, Zarir Farokh and Chesov, Dumitru and Mendelson, Marc S. and Saktiawati, Antonia Morita Iswari and van Ingen, Jakko and Eyüboǧlu, Füsun ner and Tängdén, Thomas and Võ, Luan Nguyen Quang and Riccardi, Niccolò and Moschos, Charalampos A. and Friedland, Jon S. and Lillebæk, Troels and Chandy, Sujith John and Caminero Luna, José A. and Thwaites, Guy E. and Gandra, Sumanth and Thursky, Karin A. and George, Ige Abraham and Konstantynovska, O. S. and Fatima, Razia Kaneez and Yim, Jae Joon and Kwak, Nakwon and Olaru, Ioana Diana and Gillespie, Stephen H. and Kherabi, Yousra and Perl, Sivan Haia and Grønningen, Erlend and Rodrigues, Camilla S. and Bjerrum, Stephanie and Bange, Franz Christoph and Cox, Vivian and Cirillo, D. M. and Saluzzo, Francesca and Levy-Hara, Gabriel and Wagner, Dirk and Ismail, Nazir Ahmed and Sloan, Derek J. and Eshun-Wilsonova, Ingrid and Zeng, M. and Cantero, Chloé and Vasankari, Tuula M. and Mandalakas, A. M. and Kay, Alexander W. and Ness, Tara E. and Muñoz-Torrico, Marcela Verónica and Günther, Gunar and Kukša, Liga and Guglielmetti, Lorenzo and García-Basteiro, Alberto L. and Marks, Guy B. and Pulcini, Céline and Lange, Christoph G. (2025) Clinical standards for antimicrobial stewardship in TB care. IJTLD Open, 2 (12). 716 - 726. ISSN 30057590

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Abstract

BACK GROUND: While antimicrobial stewardship (AMS) is essential for combating antimicrobial resistance (AMR), TB-specific AMS strategies remain poorly defined. METHOD S: An international panel of 62 experts par-ticipated in a Delphi process. Using a 5-point Likert scale (5 ¼ strong agreement; 1 ¼ strong disagreement), par-ticipants 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 effi-cacy, 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. C ONCLUSION: These clinical standards aim to support clinicians, programme managers, and public health au-thorities in implementing effective, TB-specific AMS strategies. © 2025 The Authors.

Item Type: Article
Additional Information: Cited by: 0; All Open Access; Gold Open Access; Green Accepted Open Access; Green Open Access
Uncontrolled Keywords: antimicrobial resistance; drug resistance; rifampicin resistance; tuberculosis
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine, Public Health and Nursing > Non Surgical Divisions
Depositing User: Ani PURWANDARI
Date Deposited: 26 Feb 2026 02:55
Last Modified: 26 Feb 2026 02:55
URI: https://ir.lib.ugm.ac.id/id/eprint/25762

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