STREAM (Evaluation of a Standardised Treatment Regimen of Anti-tuberculosis Drugs for Patients with Multidrug-resistant Tuberculosis)

STREAM is the first large-scale, multi-country clinical trial to examine shortened regimens for multidrug-resistant tuberculosis (MDR-TB). Stage 1 of the STREAM Trial began in 2012 and recruited 424 participants in Ethiopia, Mongolia, South Africa and Vietnam. Stage 1 sought to determine whether a 9-month treatment regimen that demonstrated cure rates exceeding 80% during a pilot in Bangladesh could achieve similar success in other settings. Preliminary results for Stage 1 were released in October 2017 and indicated that favorable outcomes for participants on the control (longer) and intervention (9-11-month) regimens were very similar under trial conditions. Stage 2 of the STREAM Trial began in 2016 and closed to participant enrollment in January 2020, with a total of 588 participants recruited to all arms of the trial. Stage 2 is evaluating the efficacy, safety, and cost of a 9-month all-oral, bedaquiline-containing regimen vs. the 9-month injectable-containing regimen evaluated in Stage 1.