An interruption in antituberculous therapy may or may not be significant, depending on its timing and duration.
Parameters:
(1) timing of interruption (initial phase vs continuation phase)
(2) duration of interruption
(3) duration of treatment completed
(4) percent of planned doses in continuation phase completed
(5) initial smear and culture results
(6) followup smear and culture results
(7) further interruptions in therapy
|
Timing of Interruption |
Percent of Doses Taken |
Other Parameters |
Recommendation |
|
initial |
NA |
interruption < 14 days |
continue therapy (exception 1) |
|
initial |
NA |
interruption >= 14 days |
restart therapy from beginning |
|
continuation |
< 80% |
interruption < 3 months (90 days) |
continue therapy (exceptions 1, 2) |
|
continuation |
< 80% |
interruption >= 3 months (90 days) |
restart 4 drug therapy from beginning (exceptions 2, 3) |
|
continuation |
>= 80% |
initial AFB studies negative |
no further therapy needed |
|
continuation |
>= 80% |
initial AFB studies positive |
additional therapy recommended |
Exception 1: If drug therapy is continued and further interruptions occur, then restart from beginning.
Exception 2: If repeat culture is positive, restart 4 drug therapy, check drug susceptibility tests for resistance and consider directly observed therapy (DOT).
Exception 3: If repeat cultures are negative and the patient has completed >= 9 months of therapy, then consider stopping therapy.
Specialty: Infectious Diseases, Pharmacology, clinical, Pulmonology
ICD-10: ,
