II. Indications

  1. Resistance rate in patient's Community <4%
    1. Most communities have Tb resistance >4%
  2. HIV Screening negative
  3. Immunocompetent
  4. No prior Tuberculosis Treatment v

III. Management: Overview (requires 2 phases of therapy)

  1. Initial phase: 3-4 drug regimen for 2 months
    1. Medications (4 used together in initial phase)
      1. Isoniazid and
      2. Rifampin and
      3. Pyrazinamide and
      4. Ethambutol (unless not indicated by culture)
    2. Dose timing
      1. Take once daily for 8 weeks (56 doses) or
      2. Take five times weekly for 8 weeks (40 doses)
        1. Given under direct observation
  2. Continuation phase: Double therapy for 4-7 months
    1. Medications (2 used together in continuation phase)
      1. Isoniazid and
      2. Rifampin
    2. Dose timing (18 weeks unless otherwise noted below)
      1. Once daily or
      2. Five times per week (direct observation)
    3. Duration of treatment
      1. Double therapy for 18 weeks unless exceptions below
      2. Indications for 7 month continuation phase
        1. Cavitary pulmonary Tuberculosis
        2. Positive Sputum Culture after initial phase

IV. Resources

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