Guideline

WHO consolidated guidelines on tuberculosis: module 4: treatment: drug-susceptible tuberculosis treatment.

Year of Publication

2022

Issuing Institution

WHO

Links

Recommendations

11 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

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

In all patients with drug-susceptible pulmonary TB, the use of thrice-weekly dosing is not recommended in both the intensive and continuation phases of therapy, and daily dosing remains the recommended dosing frequency

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Very low

The use of fixed-dose combination (FDC) tablets is recommended over separate drug formulations in the treatment of patients with drug-susceptible TB

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Low

Patients aged 12 years or older with drugsusceptible pulmonary TB, may receive a 4-month regimen of isoniazid, rifapentine, moxifloxacin and pyrazinamide

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Moderate

In children and adolescents between 3 months and 16 years of age with non-severe TB (without suspicion or evidence of MDR/RR-TB), a 4-month treatment regimen (2HRZ(E)/2HR) should be used

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

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

ART should be started as soon as possible within two weeks of initiating TB treatment, regardless of CD4 cell count, among people living with HIV. Adults and adolescents

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

High

ART should be started as soon as possible within two weeks of initiating TB treatment, regardless of CD4 cell count, among people living with HIV. Children and infants

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

High

In patients with tuberculous meningitis, an initial adjuvant corticosteroid therapy with dexamethasone or prednisolone tapered over 6-8 weeks should be used

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

In patients with tuberculous pericarditis, an initial adjuvant corticosteroid therapy may be used

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low