Drug-Resistant Tuberculosis: A Survival Guide for Clinicians, 3rd edition/2022 Updates

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Online only; no printed version available.

First released in 2004, the Guide is a joint publication of CITC and the Tuberculosis Control Branch of the California Department of Public Health. The Guide’s information and user-friendly tools can be used by any provider who participates in the management of individuals with drug-resistant TB.  Ten chapters cover major topics pertaining to epidemiology, diagnosis, laboratory issues, treatment, medications, pediatrics, co-morbidities and special situations, monitoring and case management, adverse reactions, and treatment of contacts.

What's new in the third edition/2022 updates of the Guide?

  • New recommendations for use of shorter (6-month) regimens, bedaquiline, pretomanid, and linezolid (BPaL) and BPaL plus moxifloxacin (BPaLM) for treatment of drug-resistant TB, including discussions on 2022 recommendations from CDC and WHO
  • New table of molecular and growth-based drug susceptibility tests available at 5 reference laboratories in the United States
  • Updated information about 21 medications used to treat tuberculosis, including a new fact sheet on Pretomanid
  • Expanded information about diagnosing and treating TB disease and LTBI in children
  • Updated data on global and U.S. burden of drug-resistant TB
  • Case management and monitoring components for BPaL/BPaLM regimens
  • Expanded discussion of hematologic adverse events, especially related to linezolid
  • Additional information on linezolid-associated peripheral neuropathy prevention, management, and prognosis
  • New section on cardiovascular toxicity including QT prolongation monitoring and management.  

How were the 2022 updates developed?

A group of 23 authors representing experts from public health and academia contributed to the writing, and a national panel of 31 peer reviewers provided input that informed the final updates. The 2022 updates of the Guide present the best practice strategies available in late 2022.

Hard data are often lacking to assist clinicians in the management of drug-resistant TB. Much-needed research is underway to more thoroughly document the clinical efficacies of various treatment regimens. For topics in which an acceptable scientific evidence base and published studies are lacking, the information presented in this Guide is based on expert opinion.

While this Guide can serve as a useful resource during care, consultation with experts remains an essential component of successful treatment. See a list of expert resources in Appendix 1.

Please note: The 2022 updates are available online only and will not be released as a printed book. Revised U.S. national DR-TB guidelines are expected in 2023/24, and CITC will prepare a 4th edition of the Survival Guide soon after.


Date of most recent third edition updates: December 2022 (Chapters 1, 8, and 9 posted June 2023)

Date of third edition release: April 2016

Date of second edition release: December 2008

Date of original release: June 2004