Drugs for tuberculosis.

Abstract

Recommendations: The standard treatment for latent tuberculosis is nine months of isoniazid taken daily, or twice weekly under direct observation by a healthcare worker. Taking isoniazid and rifapentine once weekly for 12 weeks under direct observation is an alternative for patients >12 years old. Initial therapy for patients with active or suspected tuberculosis should include isoniazid, rifampin,pyrazinamide and ethambutol until susceptibility is known. In patients with drug-susceptible pulmonary tuberculosis, the continuation phase of treatment should be a combination of isoniazid and either rifampin or rifapentine, taken for 4 or 7 months depending on risk factors. Confirmed multidrug-resistant tuberculosis or extensively drug-resistant tuberculosis should be treated with directly observed therapy in collaboration with a clinician familiar with management of these conditions. Treatment must include at least 4 drugs to which the organism is susceptible; the duration of therapy should usually be 18-24 months. Directly observed therapy by a healthcare worker should be offered to all patients with active tuberculosis to minimize treatment failure, relapse and the emergence of drug resistance.