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Principles of Treatment
Session Overview
Aims of TB Treatment
General Principles
Treatment Guidelines
Learning Objectives
REMEMBER
NO exceptions
DOT in GhantsiCan you
identify the main elements?
Directly Observed Therapy (DOT)
Epidemiologic information
e.g., circulating strains, resistance patterns
Clinical, pathological, chest x-ray findings
Microscopic examination of acid-fast bacilli
(AFB) in sputum smears
Basic Principles of
Treatment
- Rifampin (RIF)
- Pyrazinamide (PZA)
Children
Children are at an increased risk for TB
disease
If the disease is severe (meningitis,
military TB, etc.) use Category I
treatment, SM replaces EMB in small
children
For less severe disease: treat with
category III regimen
In most cases, treat with same regimens
used for adults
Infants
Treat as soon as diagnosis is suspected
Dosing of CPT in Children
Double
Single Strength
Age and weight Recommended Suspension strength
Child Tablet adult
of child daily dose 5ML syrup
100mg/20mg adult
=200mg/40 tablet
mg tablet 800mg/160m
400mg/80mg g
100mg
6 weeks to 6 sulfamethox
months asole/20mg
(<5kg) trimethoprim 2.5ml 1 tablet n/a n/a
200mg
6 months to 5 sulfamethox
years (5- asole/40mg
15Kg) trimethoprim 5ml 2 tablets 1/2 tablet n/a
400 mg
sulfamethox
6 to post asole/80mg
pubertal trimethoprim 10ml 4 tablets 1 tablet 1/2 tablet
800 mg
sulfamethox
Post pubertal asole/160mg
and Adults trimethoprim n/a n/a 2 tablets 1 tablet
Multidrug-Resistant TB (MDR TB)