Interventions for Tuberculosis Control and Elimination 2002

Isoniazid plus rifampicin plus pyrazinamide (plus a fourth drug) . . . . . . . 66
Rifampicin-containing continuation phase . . . . . . . . . . . . . . . . . . . . 67
Non-rifampicin-containing continuation phase . . . . . . . . . . . . . . . . . 68
Intermittent regimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Treatment regimens of less than six months’ duration . . . . . . . . . . . . . . 70
Clinical trials in extrapulmonary tuberculosis . . . . . . . . . . . . . . . . . . . . . . 71
Tuberculosis of peripheral lymph nodes . . . . . . . . . . . . . . . . . . . . . . . 71
Tuberculosis of the spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Tuberculosis of the central nervous system . . . . . . . . . . . . . . . . . . . . . 73
Influence of HIV infection on the choice of a regimen. . . . . . . . . . . . . . . . 74
Adverse drug events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Treatment efficacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Influence of isoniazid resistance on the choice of a regimen . . . . . . . . . . . . 77
Influence of isoniazid plus rifampicin resistance on the choice of a regimen . . 78
Strategic considerations, indications, and recommendations for the choice
of treatment regimens in a national tuberculosis control program . . . . . . . 78
Choice of first-line regimen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
8-month regimens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
6-month regimens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
12-month regimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Choice of re-treatment regimen . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Treatment of patients with organisms resistant to isoniazid and rifampicin . 82
Case holding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Directly observed treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Can emergence of drug resistance be outpaced in a national tuberculosis
program? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
The approach to management of adverse drug events . . . . . . . . . . . . . . . . . 86
The patient with hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
The patient with gastrointestinal symptoms . . . . . . . . . . . . . . . . . . . . . 88
The patient with impaired vision . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
The patient with vestibulo-cochlear toxicity . . . . . . . . . . . . . . . . . . . . 89
The patient with neurologic symptoms. . . . . . . . . . . . . . . . . . . . . . . . 89
The patient with hypersensitivity reactions or muco-cutaneous signs
and symptoms of toxicity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
The patient with hematologic abnormalities. . . . . . . . . . . . . . . . . . . . . 90
The patient with acute renal toxicity . . . . . . . . . . . . . . . . . . . . . . . . . 91
The patient with osteo-articular pain . . . . . . . . . . . . . . . . . . . . . . . . . 91
The approach to the patient with pre-existing medical conditions . . . . . . . . . 91
The patient with liver injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
The patient with renal failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
IV