Guideline Detail

Treatment of Tuberculosis: Guidelines

Source: World Health Organisation
Publication Date: January 1, 2010

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2010 World Health Organisation recommendations on the treatment of tuberculosis (TB). Topics addressed include duration of rifampicin in new patients; dosing frequency in new patients; initial regimen in countries with high levels of isoniazid resistance; TB treatment in persons living with HIV; sputum monitoring during TB treatment of smear-positive pulmonary TB patients; treatment extension in new pulmonary TB patients; previously treated patients; TB case definitions based on anatomical site of TB disease, bacteriological results, history of previous treatment, and HIV status; standard treatment regimens, including essential anti-TB drugs, standard regimens for defined patient groups, new patients, previously treated patients and multidrug resistance, standard regimens for previously treated patients, and overall considerations in selecting a country’s standard regimens; monitoring during treatment, including assessing treatment response in new and previously treated pulmonary TB patients, extrapulmonary TB, recording standardised treatment outcomes, management of treatment interruption, prevention of adverse effects of drugs, monitoring and recording adverse effects, and symptom-based approach to managing adverse effects of anti-TB drugs; comanagement of HIV and active TB disease, including HIV testing and counselling for all patients known or suspected to have TB; HIV prevention in TB patients; TB treatment in people living with HIV, cotrimoxazole preventive therapy, antiretroviral therapy (ART), drug susceptibility testing, patient monitoring during TB treatment, considerations when TB is diagnosed in people living with HIV who are already receiving ART, and HIV-related prevention, treatment, care, and support; supervision and patient support, including roles of the patient, TB programme staff, the community, and other providers, supervised treatment, using a patient-centred approach to care and treatment delivery, and prevention of treatment interruption; treatment of drug-resistant TB, including Green Light Committee Initiative, groups of drugs to treat multidrug resistant (MDR) TB, general principles in designing an MDR TB treatment regimen, programmatic strategies for treatment of MDR TB, selection of the country’s standard MDR TB treatment regimen, selection of individualised MDR TB regimens, monitoring the MDR TB patient, duration of treatment for MDR TB, treating TB with resistance patterns other than MDR, recording and reporting drug-resistant TB cases, and evaluation of outcomes; treatment of extrapulmonary TB; and treatment of TB in special situations.

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Keywords: Tuberculosis - Resource-Limited Settings, Tuberculosis - First-line Therapy, Tuberculosis - Drug Resistance, Tuberculosis - Adverse Events, HIV - Tuberculosis, HIV - Prevention, Tuberculosis - Transmission and Prevention, Tuberculosis - Drug-drug Interactions