Version May 2024
| Intensive phase* | Continuation phase¶ | Range of total doses (minimal duration) | CommentsΔ◊ | ||
| Drugs | Interval and doses§ (minimal duration) | Drugs | Interval and doses§ (minimal duration) | ||
| Regimen 1 | |||||
| INH RIF PZA EMB | Daily for 8 weeks 7 days per week for 56 doses (8 weeks), or 5 days per week for 40 doses (8 weeks)¥ | INH RIF | 7 days per week for 126 doses (18 weeks), or 5 days per week for 90 doses (18 weeks) | 182 to 130 (26 weeks) | This is the preferred regimen for patients with newly diagnosed pulmonary tuberculosis. |
| Regimen 2 | |||||
| INH RIF PZA EMB | Daily for 8 weeks 7 days per week for 56 doses (8 weeks), or 5 days per week for 40 doses (8 weeks)¥ | INH RIF | Three times weekly for 54 doses (18 weeks) | 110 to 94 (26 weeks) | Preferred alternative regimen in situations in which more frequent DOT during continuation phase is difficult to achieve. |
| Regimen 3 | |||||
| INH RIF PZA EMB | Three times weekly for 8 weeks Three times weekly for 24 doses (8 weeks) | INH RIF | Three times weekly for 54 doses (18 weeks) | 78 (26 weeks) | Use regimen with caution in patients with HIV and/or cavitary disease. Missed doses can lead to treatment failure, relapse, and acquired drug resistance. |
| Regimen 4 | |||||
| INH RIF PZA EMB | Daily for 2 weeks, then twice weekly for 6 weeks 7 days per week for 14 doses (2 weeks), then twice weekly for 12 doses‡ | INH RIF | Twice weekly for 36 doses (18 weeks) | 62 (26 weeks) | Do not use twice-weekly regimens in HIV-infected patients or patients with smear-positive and/or cavitary disease. If doses are missed, then therapy is equivalent to once weekly, which is inferior. |
INH: isoniazid; RIF: rifampin; RPT: rifapentine; PZA: pyrazinamide; EMB: ethambutol; DOT: directly observed therapy; HIV: human immunodeficiency virus.
* Daily therapy is preferred over intermittent therapy to reduce risk of relapse and drug resistance; this is particularly important during the intensive phase of treatment.
¶ During the continuation phase of treatment, daily treatment is preferred over intermittent therapy; if daily therapy is not feasible, thrice-weekly dosing is preferred over twice-weekly dosing.
Δ Based on expert opinion, patients with cavitation on initial chest radiograph and positive cultures at completion of two months of therapy should receive a seven-month (31-week) continuation phase.
◊ Pyridoxine (vitamin B6; 25 to 50 mg/day) is given with isoniazid to individuals at risk for neuropathy (eg, pregnant women, breastfeeding infants, and individuals with HIV infection, diabetes, alcoholism, malnutrition, chronic renal failure, or advanced age). For patients with peripheral neuropathy, experts recommend increasing pyridoxine dose to 100 mg/day.
§ When DOT is used, drugs may be given five days per week and the necessary number of doses adjusted accordingly. Although there are no studies that compare five with seven daily doses, extensive experience indicates that this is an effective practice. DOT should be used when drugs are administered <7 days per week.
¥ Five-day-a-week administration is always given by DOT.
‡ Alternatively, some United States tuberculosis control programs have administered intensive-phase regimens 5 days per week for 15 doses (3 weeks), then twice weekly for 12 doses.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
