Export

Capreomycin
Not recommended as an essential medicine
Section:
6. Anti-infective medicines 6.2. Antibacterials 6.2.5. Antituberculosis medicines
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ATC codes: J04AB30
EMLc
Indication
Multi-drug resistant Mycobacterium tuberculosis ICD11 code: ML32.00
INN
Capreomycin
Medicine type
Chemical agent
Antibiotic groups
ACCESS
List type
Complementary (EML)
(EMLc)
Additional notes
Reserve second-line medicine for the treatment of multidrug-resistant tuberculosis which should be used in specialized centres adhering to WHO standards for tuberculosis control
Formulations
Parenteral > General injections > IV: 1000 mg powder for injection (vial)
EML status history
First added in 1999 (TRS 895)
Changed in 2002 (TRS 914)
Changed in 2007 (TRS 950)
Removed in 2019 (TRS 1021)
Sex
All
Age
Also recommended for children
Therapeutic alternatives
The recommendation is for this specific medicine
Patent information
Patents have expired in most jurisdictions
Wikipedia
Capreomycin
DrugBank
Capreomycin
Summary of evidence and Expert Committee recommendations
An application from the WHO Global TB Programme requested the removal from the EML and EMLc of capreomycin and kanamycin for use in treatment regimens for multidrug-resistant tuberculosis (MDR-TB). The proposed deletions were in alignment with recommendations in the 2019 update of the WHO consolidated guidelines on drug-resistant tuberculosis treatment (1). One of the key outcomes of the revision was a re-classification of medicines recommended for inclusion in regimens for MDR-TB/RR-TB. Capreomycin and kanamycin had previously been recommended as Group B, second-line injectable agents along with amikacin and streptomycin (2). The 2019 guidelines no longer recommend the use of capreomycin and kanamycin as treatment options. Use of capreomycin and kanamycin was associated with poorer outcomes when compared with regimens not containing these medicines in the latest data analysis. The Expert Committee recommended the deletion of capreomycin and kanamycin from the complementary list of the EML and EMLc, noting the advice of the WHO Global TB Programme that their use is no longer recommended in WHO guidelines due to evidence that regimens involving these agents were associated with worse outcomes compared with regimens that did not include them, and that fully oral regimens should be preferred for most patients. References: 1. WHO consolidated guidelines on drug-resistant tuberculosis treatment. Geneva: World Health Organization; 2019. 2. WHO treatment guidelines for drug-resistant tuberculosis, 2016 update (WHO/HTM/TB/2016.4). Geneva,World Health Organization. 2016.