Tuberculosis
Also known as: latent TB · LTBI · TB
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ATS/CDC/ERS/IDSA Clinical Practice Guideline Update on the Treatment of Drug-Susceptible and Drug-Resistant Tuberculosis
ATS / CDC / ERS / IDSA · 2024 · 2024 update
A targeted joint update that revises selected treatment recommendations from the 2016 and 2019 joint-panel tuberculosis guidelines, focusing on shorter regimens for both drug-susceptible and drug-resistant disease.
- For people aged 12 and over with drug-susceptible pulmonary TB, a four-month rifapentine-based regimen is conditionally favoured over the standard six-month course. source
- For rifampin-resistant disease in people aged 14 and over, six-month BPaL or BPaLM regimens are strongly preferred over regimens lasting 15 months or longer. source
WHO consolidated guidelines on tuberculosis: module 4: treatment and care
World Health Organization (WHO) · 2025
WHO's consolidated module bringing together its recommendations on treating drug-susceptible and drug-resistant tuberculosis alongside patient care and support, aimed at national TB programme managers, policymakers and clinicians.
US vs EU key differences
- The US joint panel did not write its recommendations from scratch: it used GRADE-ADOLOPMENT to adapt the WHO 2022 TB treatment guidelines, re-weighing the evidence-to-decision judgements for low-burden, high-resource settings rather than WHO's high-burden, low-resource frame. source
- Because of that adoption, the headline regimens largely converge: both endorse the 4-month isoniazid/rifapentine/moxifloxacin/pyrazinamide regimen for drug-susceptible pulmonary TB from age 12, and 6-month BPaLM (or BPaL where fluoroquinolones cannot be used) for rifampin-resistant disease. source
- Currency differs: the US update is anchored to WHO's 2022 evidence base, while WHO consolidated and refreshed Module 4 in 2025, adding a new all-oral 6-month BDLLfxC regimen for MDR/RR-TB that extends coverage to children of any age and to pregnant or breastfeeding women. source
- The US guideline recommends the shortened 4-month 2HRZ(E)/2HR regimen strongly for children aged 3 months to 16 years with non-severe TB, defining non-severe as peripheral or intrathoracic lymph node disease without airway obstruction, uncomplicated effusion, or paucibacillary non-cavitary disease. source
What changed recently
- GLOBAL2022 → 20252025-04-15
The 2025 edition supersedes the December 2022 update that introduced BPaLM, adding a recommendation for a new all-oral six-month regimen (bedaquiline, delamanid, linezolid, levofloxacin and clofazimine) for multidrug- or rifampicin-resistant TB including pre-XDR disease, plus modified nine-month regimens where fluoroquinolone resistance has been excluded. The changes rest on evidence from the BEAT-Tuberculosis and endTB trials.
- US2016 → 2024 update2024-01-01
This update adds a conditional recommendation for a four-month rifapentine-moxifloxacin regimen (two months of isoniazid, rifapentine, pyrazinamide and moxifloxacin followed by two months of isoniazid, rifapentine and moxifloxacin) in people aged 12 and over with drug-susceptible pulmonary TB, as an alternative to the six-month isoniazid/rifampin/pyrazinamide/ethambutol standard carried over from 2016. The shorter regimen also sidesteps the ocular toxicity risk of ethambutol, and the update extends to shorter regimens for drug-resistant disease.
source ↗curation confidence 90%
See the full update feed for changes across every system.