Clinical Manual for Management of the HIV-Infected ... - myCME.com

Table 1. Regimens for Treatment of Tuberculosis among HIV-Infected Persons in the United States
Section 6—Disease-Specific Treatment | 6–69
Initial Phase Continuation Phase Complete Therapy
Drugs Interval and Doses
Regimen Drugs Interval and Doses
Range of Total Doses
1. Preferred Regimen
(minimum duration)
(minimum duration)
(minimum duration)
Isoniazid
• 7 days/week for 56 doses or 1a. Isoniazid 7 days/week for 126 doses or 182-130 doses
Rifampin*
Pyrazinamide
Ethambutol
5 days/week for 40 doses
(8 weeks)
1b.
if CD4 count
>100 cells/µL
Rifampin*
Isoniazid
Rifampin*
5 days/week for 90 doses
(18 weeks)#
Twice weekly for 36 doses
(18 weeks)** #
(28 weeks)
92-76 doses
(28 weeks)
2. Acceptable Alternative if CD4 >100 cells/µL
Isoniazid
• 7 days/week for 14 doses 2.
Isoniazid Twice weekly for 36 doses 62-58 doses
Rifampin*
Pyrazinamide
Ethambutol
•
(2 weeks) followed by twice
weekly for 12 doses (6 weeks)
OR
5 days/week for 10 doses
(2 weeks) followed by twice
weekly for 12 doses (6 weeks)
if CD4 count
>100 cells/µL
Rifampin* (18 weeks)** #
(28 weeks)
3. Acceptable Alternative
Isoniazid
3 times weekly for 24 doses 3. Isoniazid 3 times weekly for 54 doses 72 doses
Rifampin*
Pyrazinamide
Ethambutol
(8 weeks)
Rifampin* (18 weeks)#
(28 weeks)
Source: American Thoracic Society, CDC, and Infectious Disease Society of America. Treatment of Tuberculosis. Morb Mort Weekly Rpts Recommendations and Reports. June 20, 2003, 52(RR11);1-77.
* See Table 2 for dosages. See Table 3 for contraindications, substitutions, and dosage adjustments of rifampin. Rifampin should not be used with nevirapine or with HIV protease inhibitors other than ritonavir; rifabutin
may be substituted with appropriate dosage adjustments.
** Twice-weekly regimens (1b and 2) should not be used in persons with HIV and a CD4 lymphocyte count