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.
Clinical standards for antimicrobial stewardship in TB care / Brehm, T T; Akkerman, O W; Sotgiu, G; Tiberi, S; Chang, K-C; Dheda, K; Duarte, R; Vambe, D; Udwadia, Z F; Chesov, D; Mendelson, M; Iswari Saktiawati, A M; Van Ingen, J; Eyuboglu, F O; Tängdén, T; Quang Vo, L N; Riccardi, N; Moschos, C; Friedland, J S; Lillebaek, T; Chandy, S J; Caminero, J A; Thwaites, G; Gandra, S; Thursky, K; George, I A; Konstantynovska, O; Fatima, R; Yim, J-J; Kwak, N; Olaru, I D; Gillespie, S H; Kherabi, Y; Perl, S H; Grønningen, E; Rodrigues, C; Bjerrum, S; Bange, F; Cox, V; Cirillo, D M; Saluzzo, F; Hara, G L; Wagner, D; Ismail, N; Sloan, D J; Eshun-Wilsonova, I; Zeng, M; Cantero, C; Vasankari, T; Mandalakas, A; Kay, A; Ness, T; Torrico, M M; Günther, G; Kuksa, L; Guglielmetti, L; García-Basteiro, A L; Marks, G B; Pulcini, C; Lange, C. - In: IJTLD OPEN. - ISSN 3005-7590. - 2:12(2025), pp. 716-726. [10.5588/ijtldopen.25.0522]
Clinical standards for antimicrobial stewardship in TB care
Sotgiu, G;Dheda, K;
2025-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
