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Roadmap To Diagnosis & Treatment Of Extrapulmonary Tb
1. ROADMAP TO DIAGNOSIS & TREATMENT OF EXTRAPULMONARY TB DR. LIZA D. MARIPOSQUE OCTOBER 23, 2008
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37. Tuberculin Rxn Size ≥ 10 Recently infected person ( ≤ 2yrs) ≥ 5 Persons w/ fibrotic lesions on CXR ≥ 5 a Close contacts of TB pt. ≥ 5 HIV-infected person or persons receiving immunosupressive Tx TUBERCULIN Rxn SIZE, mm RISK GROUP
38. ≥ 15 Low risk persons c ≥ 10 Persons w/ high-risk medical conditions b TUBERCULIN Rxn SIZE, mm RISK GROUP
44. HRE e 2 mos. pregnant HRZE a 2 mos. New culture(-) HRZE a,b 2 mos. New smear or culture (+) DRUGS DURATION (month) INDICATION INITIAL PHASE
45. ZEQ + S 18-24 mos. Resistance to H + R RZE g Throughout 6 mos. Resistance or intolerance to H Failure & relapse f DRUGS DURATION (month) INDICATION INITIAL PHASE
46. HRZES i 3 mos. Standardized re-tx (susceptibility testing unavailable) 1 IV h + 3 of these 4: ethionamide, cycloserine, Q, PAS 24 mos. Resistance to all 1 st -line drugs DRUGS DURATION (month) INDICATION INITIAL PHASE
47. HRE 2 mos. Drug intolerance to Z HZE 12 mos. Drug intolerance to R DRUGS DURATION (month) INDICATION INITIAL PHASE
48. HR 7 mos. Pregnant Failure & relapse f New culture(-) New smear or culture (+) INDICATION HR a 2 mos. HR a,c,d 4 mos. DRUGS DURATION (months) CONTINUATION PHASE
49. HR 7 mos. Drug intolerance to Z HRE 5 mos. Standardized re-tx (susceptibility testing unavailable) DRUGS DURATION (months) INDICATION CONTINUATION PHASE
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53. 25-30mg/kg 15-20mg/kg Ethambutol 30-40mg/kg, max 3G 20-25mg/kg, max 2G PZA 10mg/kg, max 600mg 10mg/kg, max 600mg Rifampin 15mg/kg, max 900mg 5mg/kg, max 300mg INH TRICE-WKLY DAILY DOSE DRUG DOSAGE RECOMMENDED DOSAGE FOR INITIAL Rx OF TB IN ADULT