Guideline

Treatment of Tuberculosis: Guidelines

Year of Publication

2010

Issuing Institution

Links

Pubmed,WHO IRIS

Recommendations

19 included recommendations

New patients with pulmonary TB should receive a regimen containing 6 months of rifampicin: 2HRZE/4HR

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

High

The 2HRZE/6HE treatment regimen should be phased out

Status

Maintained

Recommended against

Strong

Certainty of evidence

High

Wherever feasible, the optimal dosing frequency for new patients with pulmonary TB is daily throughout the course of therapy

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

High

New patients with pulmonary TB may receive a daily intensive phase followed by a three-timesweekly continuation phase [2HRZE/4(HR)3], provided that each dose is directly observed

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

High

Three-times-weekly dosing throughout therapy [2(HRZE)3/4(HR)3] may be used as another alternative to Recommendation 2.1, provided that every dose is directly observed and the patient is NOT living with HIV or living in an HIV-prevalent setting

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

High

New patients with TB should not receive twiceweekly dosing for the full course of treatment unless this is done in the context of formal research

Status

Maintained

Recommended against

Strong

Certainty of evidence

High

In populations with known or suspected high levels of isoniazid resistance, new TB patients may receive HRE as therapy in the continuation phase as an acceptable alternative to HR

Status

Maintained

Recommended in favor

Conditional

New patients with pulmonary TB may receive a daily intensive phase followed by a three times weekly continuation phase [2HRZE/4(HR)3 ], provided that each dose is directly observed

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

High

Three times weekly dosing throughout therapy [2(HRZE)3 /4(HR)3 ] may be used as another alternative to Recommendation 2.1, provided that every dose is directly observed and the patient is NOT living with HIV or living in an HIV-prevalent setting

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

High

New patients with TB should not receive twice weekly dosing for the full course of treatment unless this is done in the context of formal research

Status

Updated

Recommended against

Strong

Certainty of evidence

High

TB patients with known positive HIV status and all TB patients living in HIVprevalent settings should receive daily TB treatment at least during the intensive phase

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High

Tb treatment in persons living with HIV: For the continuation phase, the optimal dosing frequency is also daily for these patients

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High

If a daily continuation phase is not possible for these patients, three times weekly dosing during the continuation phase is an acceptable alternative

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

High

It is recommended that TB patients who are living with HIV should receive at least the same duration of TB treatment as HIV-negative TB patients

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

High

For smear-positive pulmonary TB patients treated with first-line drugs, sputum smear microscopy may be performed at completion of the intensive phase of treatment

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

High

In new patients, if the specimen obtained at the end of the intensive phase (month 2) is smear-positive, sputum smear microscopy should be obtained at the end of the third month

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High

In new patients, if the specimen obtained at the end of month 3 is smear-positive, sputum culture and drug susceptibility testing (DST) should be performed

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High

In previously treated patients, if the specimen obtained at the end of the intensive phase (month 3) is smear-positive, sputum culture and drug susceptibility testing (DST) should be performed

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High

In patients treated with the regimen containing rifampicin throughout treatment, if a positive sputum smear is found at completion of the intensive phase, the extension of the intensive phase is not recommended

Status

Maintained

Recommended against

Strong

Certainty of evidence

High