Felker Irina, Solovyeva Alexandra, Ciobanu Ana, Hovhannesyan Araksya, Falzon Dennis, Dadu Andrei
Novosibirsk State Medical University, Department of Phthisiopulmonology, Novosibirsk, Russian Federation.
European TB Programme, World Health Organization Regional Office for Europe, Copenhagen, Denmark.
Euro Surveill. 2025 Jul;30(30). doi: 10.2807/1560-7917.ES.2025.30.30.2500210.
Tuberculosis (TB) preventive treatment (TPT) is crucial for preventing infection with from progressing to TB disease, especially among people in high-risk groups. The expansion of novel TPT regimens for drug-susceptible TB is a notable advancement in TB care. However, managing contacts of drug-resistant TB patients remains a major challenge, particularly in Eastern Europe and Central Asia. In 2020, the World Health Organization (WHO) recommended TPT for high-risk household contacts of multidrug-resistant (MDR) or rifampicin-resistant (RR) TB patients; this was further reinforced in 2024 with a recommendation of a 6-month levofloxacin (6-Lfx) regimen. This Perspective discusses the early adoption of 6-Lfx for MDR/RR-TPT in the WHO European Region. In 2023, 38 of 53 WHO European Region countries reported on 6-Lfx use, with only eight confirming its use for MDR-TB contact persons. Accelerating the adoption of the 6-Lfx regimen and other evidence-backed TPT regimens is crucial for achieving TB elimination in the WHO European Region. Addressing challenges such as slow uptake of the recommendations, low awareness in affected communities and resource shortages are essential for success.
结核病预防性治疗（TPT）对于预防感染发展为结核病至关重要，尤其是在高危人群中。新型药物敏感结核病TPT方案的扩展是结核病治疗方面的一项显著进展。然而，管理耐多药结核病患者的接触者仍然是一项重大挑战，特别是在东欧和中亚地区。2020年，世界卫生组织（WHO）建议对耐多药（MDR）或利福平耐药（RR）结核病患者的高危家庭接触者进行TPT；2024年，随着推荐使用6个月左氧氟沙星（6-Lfx）方案，这一建议得到了进一步加强。本观点文章讨论了在WHO欧洲区域早期采用6-Lfx进行耐多药/利福平耐药结核病预防性治疗的情况。2023年，WHO欧洲区域53个国家中的38个报告了6-Lfx的使用情况，但只有8个国家确认将其用于耐多药结核病接触者。加速采用6-Lfx方案和其他有证据支持的TPT方案对于在WHO欧洲区域实现消除结核病至关重要。应对建议采纳缓慢、受影响社区意识淡薄和资源短缺等挑战对于取得成功至关重要。
