III. Approach
- Treat with 3 or more drugs to which Tb is sensitive
- Consider starting 5-7 drugs before susceptibility known
- Indicated for high risk or previously treated Tb
- Continue treatment for 12-24 months after Cultures negative
- Parenteral drugs may increase rate of cure
- Lung resection with medications may increase cure rate
IV. Precautions
- This protocol is from 2003 without available new guidance to use for update as of 2016 review
- Multi-drug resistance requires expert local opinion for guidance
- Avoid use of fluouroquinolones for routine Pneumonia (non-Tb) to help prevent Fluoroquinolone resistant Tb
V. Management
- Standard Main Drugs
- Secondary additional drugs
- Aminoglycoside or Capreomycin
- Ciprofloxacin or Ofloxacin
- Cycloserine, Ethionamide, or para-Aminosalicylic Acid
- Bedaquiline (Sirturo)
- Delamanid (Deltyba)