Tuberculosis: First Revised Guidelines Issued Since 1994
April 11, 2003
The American Thoracic Society, CDC, and the Infectious Diseases Society of America have released their first completely revised TB prevention, control, diagnosis and treatment guidelines since 1994. The jointly developed guidelines, first published in 1971, are intended to advise public health programs and health care providers on all aspects of the clinical and public health management of TB in low-incidence countries. The new guidelines focus on the latest aspects of therapy, including drug administration, fixed-dose combination preparations, monitoring and managing adverse effects, and drug interaction.Adapted from:
Directly observed therapy is advised because of its higher rates of treatment completion. The document lists four recommended regimens for treating patients with TB caused by drug-susceptible organisms. Each regimen has an initial phase of two months, followed by the choice of several options for the continuation period of four to seven months. The new guidelines recommend treatment regimens based on the strength of the scientific evidence supporting their use. The responsibility for successful treatment is now assigned to the public health program or private provider, not to the patient. Treatment completion is defined by the number of doses ingested as well as by the duration of treatment administration.
The guidelines recommend that all TB patients have counseling and testing for HIV infection by the time treatment is initiated, if not sooner. The management of HIV-related TB is complex, requiring expertise in both diseases. Expert management is especially important since HIV patients often take numerous medications, some of which interact with TB drugs. To access the full recommendations, visit www.thoracic.org/adobe/statements/treattb.pdf (PDF).
TB & Outbreaks Week
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.