Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK; Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Department of Infectious Diseases, Galliera Hospital, Genova, Italy.
Int J Infect Dis. 2019 Mar;80S:S68-S72. doi: 10.1016/j.ijid.2019.01.040. Epub 2019 Jan 25.
MDR-TB is a growing challenge worldwide, and an obstacle to TB elimination. It is apparent that TB is being replaced by small but growing number of resistant cases with an anticipated 2 million cases of MDR-TB within the next two decades. One of the potential causes of MDR-TB is iatrogenic and we risk losing our new drugs through inexperience and repetition of basic errors of adding single active drugs to failing regimens. Discussion of MDR-TB cases with senior colleagues is not only best practice; it is now embedded in the WHO and many national and local guidelines. TB Consilia act as gatekeepers to the new drugs, monitor guideline adherence and mandate active drug safety monitoring. TB Consilia are also excellent educational tools. TB Consilia are now recommended by funding bodies, the WHO and manufacturers of drugs available for compassionate use in the hope that these drugs will be protected and will continue to be useful in the future. This article briefly discusses Consilia, their origin and evolution and gives some examples of how they operate.
耐多药结核病（MDR-TB）是全球日益严峻的挑战，也是结核病消除工作的障碍。很明显，结核病正被数量虽小但不断增加的耐药病例所取代，预计未来二十年将有 200 万例耐多药结核病。耐多药结核病的一个潜在原因是医源性的，我们有可能因为缺乏经验和重复添加单一活性药物到失败方案的基本错误而失去新的药物。与资深同事讨论耐多药结核病病例不仅是最佳实践，现在也被世界卫生组织（WHO）和许多国家及地方指南所采纳。结核病咨询委员会（TB Consilia）充当新药的把关人，监测指南的遵守情况并要求对活性药物进行安全监测。TB Consilia 也是极好的教育工具。现在，资金机构、世界卫生组织和可用药物的制造商都推荐使用这些咨询委员会，希望这些药物能得到保护，并在未来继续发挥作用。本文简要讨论了 Consilia 的起源、发展及其运作方式，并提供了一些实例。
