Treatment of latent TB infection is essential

for controlling and eliminating TB in the

United States.

cdc.gov, 2011

Phases of disease
Latent phase
Active phase or TB disease

Special populations

Pregnancy
people with HIV infection
drug resistance
children.
cdc.gov, 2011

TB disease can be treated by

taking several drugs for 6 to 9
months.
There are 10 drugs currently
approved by the U.S. Food and
Drug Administration (FDA) for
treating TB
cdc.gov, 2011

Of the approved drugs, the first-line anti-TB

agents that form the core of treatment
regimens include:
isoniazid (INH)
rifampin (RIF)
ethambutol (EMB)
pyrazinamide (PZA)
cdc.gov, 2011

2 Phases
Initial phase
2 months

Continuation phase
4-7 months

cdc.gov, 2011

Preferred
Regimen

Alternative
Regimen

Alternative
Regimen

Initial Phase
Daily INH, RIF, PZA,
and EMB* for 56
doses (8 weeks)

Initial Phase
Daily INH, RIF, PZA,
and EMB* for 14
doses (2 weeks),
then twice weekly
for 12 doses (6
weeks)

Initial Phase
Thrice-weekly INH,
RIF, PZA, and EMB*
for 24 doses (8
weeks)

Continuation Phase
Daily INH and RIF
for 126 doses (18
weeks)
or
Twice-weekly INH
and RIF for 36
doses (18 weeks)

Continuation Phase
Twice-weekly INH
and RIF for 36
doses (18 weeks)

Continuation Phase
Thrice-weekly INH
and RIF for 54
doses (18 weeks)

Untreated TB disease represents a

greater hazard to a pregnant woman
and her fetus than does its treatment.
Although the drugs used in the initial
treatment regimen cross the placenta,
they do not appear to have harmful
effects on the fetus.

cdc.gov, 2011

In general, the same methods are used in

treating tuberculosis in children as are used in
treating tuberculosis in adults (America Lung
Association, 2010).
Primary difference is the use of ethambutol .
Side effect of ethambutol is impaired vision
which is difficult to monitor in young children
Ethambutol is not routinely recommended for
children less than five years old
ALA, 2010

6-month regimen consisting of

An initial phase of isoniazid (INH), a rifamycin (see Drug

Interactions below), pyrazinamide (PZA), and ethambutol
(EMB) for the first 2 months.
A continuation phase of INH and a rifamycin for the last 4
months.

Six months should be considered the minimum

duration of treatment for adults with HIV, even for
patients with culture-negative TB.
Prolonging treatment to 9 months (extend
continuation phase to 7 months) for HIV-infected
patients with delayed response to therapy (e.g.,
culture positive after 2 months of treatment) should
be strongly considered.
cdc.gov, 2011

Patients with (CD4 counts < 100/l) should

be treated with
daily or three-times-weekly therapy in both the
initial and the continuation phases.
Twice weekly therapy may be considered in
patients with less-advanced immunosuppression
(CD4 counts 100/l).
Once-weekly INH/rifapentine in the continuation
phase should not be used in any HIV-infected
patient.
cdc.gov, 2011

If they stop taking the drugs too soon

they can become sick again

If they do not take the drugs correctly,

the TB bacteria that are still alive may become
resistant to those drugs.
TB that is resistant to drugs is harder and more
expensive to treat.
CDC 2011, cdc.gov

Directly Observed Therapy (DOT)

Best way to remember to take medicine
take your medicines at an agreed place while the
health care worker watches.

You will meet with a health care worker

every day or several times a week.
Convenient location
TB clinic, your home or work
cdc.gov, 2011

http://www.cdc.gov/tb/topic/treatment/defau
lt.htm
http://www.lung.org/lung-disease/tuberculosi
s/tuberculosis-in-children-fact.html