2003 TB Disease Treatment Statement
The February 15, 2003 issue of the American Journal of Respiratory and Critical Care Medicine published the revised Statement on the Treatment of Tuberculosis. Organizations collaborating to sponsor this revised statement are the American Thoracic Society, the Centers for Disease Control and Prevention and the Infectious Diseases Society of America.
On June 20, 2003, the CDC republished this document in the Morbidity and Mortality Weekly Report. Click here for the complete copy of the TB Treatment Statement published in the June 20, 2003 issue of CDC's Morbidity and Mortality Report (MMWR). The following excerpt is a summary of the new recommendations, and it can be found on page 1 of the MMWR document. (Citation)
- "The responsibility for successful treatment is clearly assigned to the public health program or private provider, not to the patient."
- "It is strongly recommended that the initial treatment strategy utilize patient-centered case management with an adherence plan that emphasizes direct observation of therapy."
- "Recommended treatment regimens are rated according to the strength of the evidence supporting their use. Where possible, other interventions are also rated."
- "Emphasis is placed on the importance of obtaining sputum cultures at the time of completion of the initial phase of treatment in order to identify patients at increased risk of relapse."
- "Extended treatment is recommended for patients with drug-susceptible pulmonary tuberculosis who have cavitation noted on the initial chest film and who have positive sputum cultures at the time 2 months of treatment is completed."
- "The roles of rifabutin, rifapentine, and the fluoroquinolones are discussed and a regimen with rifapentine in a once-a-week continuation phase for selected patients is described."
- "Practical aspects of therapy, including drug administration, use of fixed-dose combination preparations, monitoring and management of adverse effects, and drug interactions are discussed."
- "Treatment completion is defined by number of doses ingested, as well as the duration of treatment administration."
- "Special treatment situations, including human immunodeficiency virus infection, tuberculosis in children, extrapulmonary tuberculosis, culture-negative tuberculosis, pregnancy and breastfeeding, hepatic disease and renal disease are discussed in detail."
- "The management of tuberculosis caused by drug-resistant organisms is updated."
- "These recommendations are compared with those of the WHO and the IUATLD and the DOTS strategy is described."
- "The current status of research to improve treatment is reviewed."
Click
here for the complete TB Treatment Statement.
*Centers for Disease Control and Prevention. Treatment of Tuberculosis, American Thoracic Society, CDC, and Infectious Diseases Socity of America. MMWR 2003; 52 (No. RR-11): p. 1.
