Diagnostic category, regimens, and indications | Regimen*¶Δ | |||
Intensive phase | Continuation phase | |||
Regimen | Duration | Regimen | Duration | |
Pulmonary TB: drug susceptible (presumed or confirmed) | ||||
Traditional 6-month regimen (daily)[2]
| Isoniazid Rifampin Pyrazinamide Ethambutol | 2 months | Isoniazid Rifampin | 4 months |
Shortened 4-month traditional regimen (daily)
| Isoniazid Rifampin Pyrazinamide Ethambutol (use according to local guidance) | 8 weeks | Isoniazid Rifampin | 8 weeks |
Rifapentine-moxifloxacin-based regimen (daily)
| Isoniazid Rifapentine Moxifloxacin Pyrazinamide | 8 weeks | Isoniazid Rifapentine Moxifloxacin | 9 weeks |
Extrapulmonary TB: drug susceptible (presumed or confirmed) | ||||
Traditional 6-month regimen (daily)
| Isoniazid Rifampin Pyrazinamide Ethambutol | 2 months | Isoniazid Rifampin | 4 months |
12-month regimen (daily)
| Isoniazid Rifampin Pyrazinamide Ethambutol (or ethionamide or levofloxacin◊) | 2 months | Isoniazid Rifampin | 10 months[3] |
6-month intensive regimen (daily)§ | Isoniazid Rifampin Pyrazinamide Ethionamide | 6 months |
TB: tuberculosis; HIV: human immunodeficiency virus.
* For infants and young children, isoniazid tablets and can be pulverized, and the contents of rifampin capsules can be suspended in a flavored liquid or sprinkled on semisoft foods. Pyridoxine (vitamin B6) supplementation is not routinely recommended for children receiving isoniazid but should be considered for exclusively breastfed infants, malnourished children or those with diets poor in pyridoxine, and children with HIV infection. The isoniazid/B6 suspension (available in the United States) uses a sorbitol base that can induce diarrhea, especially at higher doses.
¶ Direct observation of drug administration is strongly recommended.
Δ Refer to separate UpToDate tables for drug dosing.
◊ While ethambutol is recommended by the World Health Organization as the fourth drug to be used in this regimen, in practice, ethionamide or levofloxacin is used more commonly.
§ In children and adolescents with bacteriologically confirmed or clinically diagnosed TB meningitis (without suspicion or evidence of multidrug-resistant/rifampin-resistant-TB), the World Health Organization has endorsed a 6-month intensive regimen as an alternative option to the 12-month regimen.Do you want to add Medilib to your home screen?