Treatment should begin promptly when clinical, laboratory and radiographic indices support a presumptive diagnosis of TB disease. Therapy should be initiated while awaiting AFB smear, culture and susceptibility results. The susceptibility results of a known source case, if identified, may be used to guide empiric therapy, provided there is no possibility of an alternative source (eg, recent foreign travel).62,71 Empiric therapy with INH, RMP, EMB, and PZA, unless contraindicated, is the recommended treatment of choice. If the source case is known to have fully drug-susceptible disease, EMB can be omitted. If there is a strong possibility of drug-resistant disease, expert consultation is strongly advised.
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