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Treatment of Tuberculosis and Latent TB Infection Division of TB Control Virginia Department of Health
TB Diagnosis ,[object Object],[object Object],[object Object]
TB Diagnosis ,[object Object],[object Object],[object Object]
Diagnosis of Pulmonary TB (80-85% of TB Cases) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of Pulmonary TB ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of Pulmonary TB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of Pulmonary TB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of Pulmonary TB ,[object Object],[object Object],[object Object],[object Object],[object Object]
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
Diagnosis of Pulmonary TB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Tests for  M.tb ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Tests for  M.tb ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Tests for  M.tb ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Laboratory Tests for  M.tb ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis/Follow-up of Pulmonary vs.  Extra-Pulmonary TB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis and Treatment of Pulmonary vs. Extra-Pulmonary TB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of TB Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antituberculosis Drugs Currently in Use in the US ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of TB Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of TB Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
  Drug resistant TB ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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)
Drug Side Effects/Toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TB Treatment in Patients with Other Medical Conditions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TB Treatment in Patients with Other Medical Conditions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TB treatment in special populations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TB treatment in special populations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of Latent TB Infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of Latent TB Infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
  VDH/DTC Phone: 804 864 7906 Fax: 804 371 0248 www.vdh.virginia.gov
Thank you Questions?

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Tb And Ltbi Treatment

  • 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)
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  • 31. VDH/DTC Phone: 804 864 7906 Fax: 804 371 0248 www.vdh.virginia.gov

Editor's Notes

  1. 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