D'Ambrosio Lia, Tadolini Marina, Centis Rosella, Duarte Raquel, Sotgiu Giovanni, Aliberti Stefano, Dara Masoud, Migliori Giovanni Battista
World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Via Roncaccio 16, 21049, Tradate, Italy.
Section of Infectious Diseases, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Massarenti 11, 40138, Bologna, Italy.
Int J Infect Dis. 2015 Mar;32:156-60. doi: 10.1016/j.ijid.2014.12.024.
Multi-drug and extensively drug-resistant tuberculosis (MDR/XDR-TB) are considered a serious threat for TB control and elimination. The outcome of these patients is still largely unsatisfactory as of today, with treatment success rates being consistently below 50% at global level. The World Health Organization (WHO) recommends that management of MDR-TB cases is supported by a specialized team, including complementary medical professionals able to cover several perspectives (clinical, both for adults and children; surgical; radiological; public health; psychological; nursing, among others). Implementation of such a body (known as Consilium in most of the former Soviet Union countries) is often a pre-requisite to apply for international TB control funding and concessionally priced medicines to treat M/XDR-TB cases. The primary objective of the ERS/WHO TB Consilium is to provide clinical consultation for drug-resistant TB and other difficult-to-treat TB cases, including co-infection with HIV and paediatric cases. Through technical guidance to clinicians managing complex TB cases, the main contribution and outcome of the initiative will be a public health response aimed at achieving correct treatment of affected patients and preventing further development of drug resistance. The Consilum's secondary objective is to ensure monitoring and evaluation of clinical practices on the ground (diagnosis, treatment and prevention).
耐多药和广泛耐药结核病（MDR/XDR-TB）被视为结核病控制和消除工作的严重威胁。截至目前，这些患者的治疗结果仍很不理想，全球层面的治疗成功率一直低于50%。世界卫生组织（WHO）建议，耐多药结核病病例的管理应由一个专业团队提供支持，该团队包括能够涵盖多个视角的补充医疗专业人员（临床，包括成人和儿童；外科；放射学；公共卫生；心理；护理等）。设立这样一个机构（在前苏联国家大多称为顾问委员会）往往是申请国际结核病控制资金和以优惠价格购买治疗M/XDR-TB病例药物的先决条件。欧洲呼吸学会/世界卫生组织结核病顾问委员会的主要目标是为耐多药结核病及其他难治性结核病病例提供临床咨询，包括合并感染艾滋病毒的病例和儿科病例。通过对管理复杂结核病病例的临床医生提供技术指导，该倡议的主要贡献和成果将是一种公共卫生应对措施，旨在实现对受影响患者的正确治疗并防止耐药性的进一步发展。顾问委员会的次要目标是确保对实际临床实践（诊断、治疗和预防）进行监测和评估。
