Page 210 - fourth year book

COMMUNICABLE DISEASES (T.B)

 WHO recommended any of the following treatment regimens for
LTBI: -

- Isoniazid (INH) regimen: is the standard treatment for LTBI. It works
very well to prevent TB but it should be taken daily for 6-9 months
and usually given with vitamin B6 or pyridoxine.

- Isoniazid (INH) and Rifapentine (RPT) Regimen, also known as 3HP,
is another regimen that is recommended as an alternative to INH
monotherapy for both adults and children. it is taken once a week for
12 weeks. DOT is strongly recommended for this regimen with
monthly clinical monitoring of patients.

- Isoniazid (INH) plus rifampicin (RIF) regimen: given for 3 months
(3RH) and it is recommended for children and adolescents

II- Treatment for TB Disease

 The major goals of treatment for TB disease are: cure, minimize risk of
death and disability and reduce the risk of transmission of TB bacteria
to others.
 For each patient with newly diagnosed TB disease, a specific

treatment and monitoring plan should be developed which include:

- Description of the TB treatment regimen
- Methods of assessing and ensuring adherence to this regimen
- Methods to monitor for adverse reactions

- Methods for evaluating treatment response.

 The standard of care for initiating treatment of TB disease is four-
drug therapy to prevent drug-resistant; using the first-line anti-TB
agents that form the core of treatment regimens
 There are four treatment regimens for TB disease each of which
consists of an initial 2-month treatment phase followed by a

continuation phase of either 4 or 7 months
 Patients should be clearly informed about possible adverse reaction of
anti-TB drugs and when to seek consultation, consequences of not
taking drugs correctly, infection control measures and the potential
need for isolation

 Nearly all the treatment regimens for TB disease can be given
intermittently if using DOT to be more cost-effective, reduce the

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