Clinical standards for antimicrobial stewardship in TB care

Area of Science:

• Infectious Diseases
• Public Health
• Microbiology

Background:

• Antimicrobial stewardship (AMS) is crucial for addressing antimicrobial resistance (AMR).
• Specific AMS strategies for tuberculosis (TB) are not well-defined.
• There is a need for standardized approaches to TB-specific AMS.

Purpose of the Study:

• To define and establish consensus-based clinical standards for TB-specific antimicrobial stewardship (AMS).
• To provide a framework for implementing effective TB-focused AMS strategies globally.

Main Methods:

• A Delphi process involving 62 international experts was conducted.
• Ten draft clinical standards were evaluated using a 5-point Likert scale.
• Consensus was defined as ≥90% agreement among experts for standard adoption.

Main Results:

• All 10 proposed clinical standards achieved the consensus threshold and were adopted.
• Standards cover TB integration into AMR plans, surveillance, education, AMS activities, expert consultation, preventive treatment, diagnostics, regimen prioritization, monitoring, and failure assessment.
• The adopted standards provide a comprehensive framework for TB-specific AMS.

Conclusions:

• The developed clinical standards aim to guide clinicians, program managers, and public health authorities.
• These standards facilitate the implementation of effective, TB-specific AMS strategies.
• The guidelines address critical aspects of TB care to combat AMR.