Interruptions are common in treatment of TB disease. Generally speaking, treatment interruptions are more concerning in people with extensive disease (eg, smear positive, cavitary or disseminated disease) and in people with advanced immune suppression (eg, untreated HIV). Treatment interruptions are also more concerning during the intensive phase, when uninterrupted treatment is needed to achieve a rapid reduction in bacillary burden. Reinstituting therapy after treatment interruption should be performed in consultation with the patient and a TB expert. Table 3 is based on expert guidance and modified from existing guidelines and protocols.1,54
Table 3. Management of treatment interruptions in first line therapy.
Treatment phase | Total length of interruption | Approach |
---|---|---|
Intensive phase | <14 days | Continue therapy to complete intensive phase within three months |
≥14 days | Restart therapy | |
Continuation phase | <2 months | Continue therapy to complete treatment |
≥2 months and ≥80% of medications taken | Continue therapy to complete treatment | |
≥2 months and <80% of medications taken | Restart therapy from start of intensive phase |
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