| Treatment of adults with pulmonary tuberculosis |
|
Adults with pulmonary tuberculosis are treated with a combination of rifampicin, isoniazid, pyrazinamide and ethambutol for the first two months followed by rifampicin and isoniazid for a further four months (including pleural effusion / mediastinal lymphadenopathy). Ethambutol is omitted if the patient is at low risk of resistance to isoniazid (previously untreated caucasian who is HIV negative and who has not been in contact with a patient with known drug resistant organisms). If pyrazinamide is omitted then treatment should be given for nine months with ethambutol being given for the initial two months .
|
|
Recommended
dosages of standard antituberculosis drugs
|
||
|
Drug (daily doses)
|
weight
|
dose
|
|
Isoniazid
|
300 mg
|
|
|
Rifampicin
|
<50 kg >50 kg |
450 mg 600 mg |
|
Pyrazinamide
|
<50 kg >50 kg |
1.5g 2g |
|
Ethambutol
|
15 mg/kg
|
|
|
Intermittent
treatment
|
||
|
Drug
|
(Intermittent
dosage)
|
weight
dose
|
|
Isoniazid
|
15 mg/kg three times a week |
|
|
Rifampicin
|
600-900
mg three times a week
|
|
|
Pyrazinamide
|
<50 kg >50 kg <50 kg >50 kg |
2g three times a week 2.5 g three times a week 3g three times a week 3.5 g three times a week |
| Ethambutol |
30 mg/kg three times a week 45 mg/kg three times a week |
|
|
Drugs
|
Month
|
Drug
|
Month
|
Total
months
|
|
|
Respiratory Non Respiratory |
HRZ
(E)
|
2
|
HR
|
4
|
6
|
|
Meningitis CNS |
HRZ
(E)
|
2
|
HR
|
10
|
12
|
|
Chemo-prophylaxis
|
H HR |
6 3 |
6 3 |
||
|
Chemo
prophylaxis (Isoniazid resistant organism)
|
R
|
6
|
6
|
||
|
R
= rifampicin; H = isoniazid; Z = pyrazinamide; E = ethambutol.
|
|||||
|
Reference Joint Tuberculosis Committee of the British Thoracic Society. Thorax 1998;53:536-548 |
Copyright © cysticfibrosismedicine