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Can you treat non-severe tuberculosis with a shorter regimen?

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Turkova A et al (N Engl J Med 2022;386:911–922) have conducted an open-label, treatment-shortening, noninferiority trial involving children with nonsevere, symptomatic, presumably drug-susceptible, smear-negative tuberculosis (TB) in Uganda, Zambia, South Africa, and India. Study subjects were randomly assigned to 4 months (16 weeks) or 6 months (24 weeks) of standard first-line antituberculosis treatment with paediatric fixed-dose combinations as recommended by the WHO. All the participants initially received 8 weeks of standard therapy with isoniazid, rifampin, and pyrazinamide (fixed-dose combination formulation), with or without ethambutol according to local guidelines (intensive phase). This treatment was followed by standard therapy …

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