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TB Diagnosis Treatment Guidelines Virginia Health Dept
1. Treatment of Tuberculosis and Latent TB Infection Division of TB Control Virginia Department of Health
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9. Yield of smear and culture from repeated sputum induction for the diagnosis of pulmonary tuberculosis Int J Tuberc Lung Dis. 2001 Sep;5(90:855-60. Al Zahrani K, et al. Induced sputum (% yield) 100 99 91 70 AFB culture 98 91 81 64 AFB smear four three two one specimen
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22. Resistance to First Line Antimicrobial Agents Treatment of Cases and Contacts I = INH; R = Rifampin; E = Ethambutol; Z = Pyrazinamide; S = Streptomycin (Standard treatment = IREZ x8wk + IR x18wk) 174 (6%) S IE + second line med; Extend treatment to 12-18mo 0 RZ IZ + second line med: Extend treatment to 12-18mo 0 RE 8 (<1%) IZ 10 (<1%) IE Second line meds: Treat > 24 mo 13 (<1%) IREZ E + second line meds: Treat 24 mo 20 (<1%) IRZ Z + second line meds: Treat 24 mo 14 (<1%) IRE EZ + second line meds; Treat 18-24 mo 29 (1%) IR Extend treatment to 9mo 13 (<1%) Z 13 (<1%) E Extend treatment to 12-18mo 11 (<1%) R R for contacts 169 (6%) I Treatment Modifications # Resistant Isolates Drug(s)
Preventive therapy may be given to persons who have a negative skin test reaction High-risk contacts Children younger than 6 months of age who have been exposed to TB Persons receiving preventive therapy are those who have a positive skin test, and those who are: more likely to be exposed to or infected with M. tuberculosis more likely to develop TB disease once infected All persons receiving preventive therapy should receive a medical evaluation to: Exclude the possibility of TB disease Determine whether they have ever been treated for TB infection or disease Identify any medical problems that may complicate therapy or require more careful monitoring
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