It depends on what form of TB.

For developments regarding treatment of TB including drug-susceptible TB, please see:

https://www.tballiance.org/portfolio/regimen/bpamz

https://www.tballiance.org/portfolio/regimen/bpal

For developments specifically regarding treatment of MDR-TB, please see:

http://www.who.int/tb/Short_MDR_regimen_factsheet.pdf

For developments regarding prophylactic treatment of TB, please see:

https://www.nih.gov/news-events/news-releases/one-month-tuberculosis-prophylaxis-effective-nine-month-regimen-people-living-hiv

Great info Ronan, thanks. But given that it would still be a 3 month treatment at best I feel the emphasis should still be on approaches to ensure adherence!

One issue is patient compliance with treatment regimens. This must be carefully monitored. Another issue is treatment resistance and that suggests certainty of treatment success before making a claim of cure.

Dear Glenn,

There are currently many trials going on to find such ultra-short regimens for cure of TB Disease.

A number of such trials were presented in the recently held CROI. Two of these are accessible in the references below:

1. A one-month antibiotic regimen to prevent active tuberculosis (TB) disease was found to be as safe and effective as the standard nine-month therapy for people living with HIV, according to the results of a large international clinical trial. Adults and adolescents in the trial were more likely to complete the short-course regimen — consisting of daily doses of the antibiotics rifapentine and isoniazid for four weeks—than the standard nine-month regimen of daily isoniazid.

S Swindells et al. One month of rifapentine/isoniazid to prevent TB in people with HIV: Brief-TB/A5279. Oral presentation at the 2018 Conference on Retroviruses and Opportunistic Infections, Boston, Massachusetts.

2. Higher rifampin doses safe for patients with pulmonary TB

Results of a phase 2 randomized clinical trial show that up to twice the standard daily dose of rifampin was safe in patients with pulmonary tuberculosis. The findings suggest that TB therapy can be shortened using higher doses, which could potentially improve outcomes without increasing toxicity.

Velásquez GE, et al. Abstract 39LB. Presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2018; Boston.

http://tbonline.info/posts/2018/3/7/higher-rifampin-doses-safe-patients-pulmonary-tb/

These are promising preliminary reports suggesting that in a short time to come (after results accrue from larger trial studies) effective ultra-short anti-TB regimens will soon be available.

Dear Yovan,

Experience in working with tuberculosis patients in the field of community medicine shows that there is no shorter duration of course for their treatment. The disease itself takes six months to two years to become active TB.

There are no new TB drugs except for Bedaquiline, which has adverse drug reaction such as cardio-toxicity.

We must use our knowledge and experience judicially to treat TB patients. I noticed some CAT I TB patients declared 'failure' at 5 months and changed to CAT II where they received treatment for 8 months. That meant that total duration of treatment was 13 months.

It is very very difficult to adhere to long treatment for patient but we the Health Professionals have to prevent them from becoming defaulters.

Till the time there is a well evidenced effective ultra-short anti-TB regimen we must religiously adhere to WHO recommended regimes.

Dear Yovan, decades ago as you put it in your question, there were actually longer than 6 months TB treatment regimen.It used to be between 9-12 months. Then with the introduction of the fixed dose combination therapy in 2007, treatment duration reduced to 6 months for new cases and 8 months for retreatment cases. Currently the new policy is to administer a 6 month duration course for both new and retreatment cases. Adoption of Community-based TB care strstegy is helping to improve treatment adherence.

Hopefully shorter regimes will emerge in the future but in the meantime a key issue is treatment/adherence. Self-treatment approx 60% and DOT/eDOT approx 80%. There are major challenges in ensuring behaviour change and I attach a brief paper that illustrates the key points.

Health promotion and preventive steps are very important. I hope that people's health can be better and in "the best" state after they know how to prevent themselves from diseases and increase their health in many ways, maybe from the environment sanitation, personal hygiene, immunization, do exercise regularly, adequate nutrition, adequate take rest or have enough sleep, and so on. It must be better if we can prevent diseases not occur than do the treatment and rehabilitation after the diseases come.

Dear Hindriek

As you know there is a standard regimen for anti-tuberculosis therapy and this regimen extended for 6 months. Even if there is a duration less than 6 month, the possibility and chance for sudden antimicrobial resistance will occur. At other meaning, In adequate therapy will cause selection and emergence of drug resistance mutants of Mycobacterium tuberculosis.

Best regard

Good luck.