Regimens

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Consult the ATS/CDC/IDSA "Treatment of Tuberculosis" statement for more specific detail on the regimens listed below as well as alternative regimens not listed here.

4 Drug Combination (INH, RIF, PZA, EMB)

Regimen 1 (Most Preferred)

Initial Phase

Interval & Doses (minimal duration)

7 days/wk for 56 doses (8 wks) or 5 days/wk for 40 doses (8 wks)

Continuation Phase

2 - Drug Combination Interval  & Doses (minimum duration) Range of Total Doses (minimum duration)
INH/RIF 7 days/wk for 126 doses
(18 wks) or 5 days/wk for
90 doses (18 wks)
182-130 (26 wks)
INH/RIF 2x/wk for 36 doses (18 wks)
92-76 (26 wks)
INH/RPT 1x/wk for 18 doses (18 wks)
74-58 (26 wks)

Interval  & Doses (minimum duration)
When DOT is used, drugs may be given 5 days/week & the necessary number of doses adjusted accordingly
Patients with cavitation on initial CXR & positive cultures at completion of 2 months of therapy should receive a 7-month (31 weeks; either 217 doses {daily} or 62 doses {2x/week) continuation phase

INH/RIF
Not recommended for HIV-infected patients with CD4+ cell counts <100cells/µL

INH/RPT
Should only be used in HIV-negative patients who have negative sputum smears upon completion of 2 months of therapy & who do not have cavitation on initial chest radiograph.  During this regimen, if 2-month specimen is culture positive, treatment should be extended an extra 3 months.

Regimen 2

Initial Phase

Interval & Doses (minimal duration)

7 days/wk for 14 doses (2 wks) then 2x/wk for 12 doses (6 wks) or
5 days/wk for 10 doses (2 wks)
then 2x/wk for 12 doses (6 wks)

Continuation Phase

2 - Drug Combination Interval  & Doses (minimum duration)
Range of Total Doses (minimum duration)
INH/RIF 2x/wk for 36 doses (18 wks)
62-58 (26 wks)
INH/RPT 1x/wk for 18 doses (18 wks)
44-40 (26 wks)

Interval  & Doses (minimum duration)
When DOT is used, drugs may be given 5 days/week & the necessary number of doses adjusted accordingly
Patients with cavitation on initial CXR & positive cultures at completion of 2 months of therapy should receive a 7-month (31 weeks; either 217 doses {daily} or 62 doses {2x/week) continuation phase

INH/RIF
Not recommended for HIV-infected patients with CD4+ cell counts <100cells/µL

INH/RPT
Should only be used in HIV-negative patients who have negative sputum smears upon completion of 2 months of therapy & who do not have cavitation on initial chest radiograph.  During this regimen, if 2-month specimen is culture positive, treatment should be extended an extra 3 months.

Regimen 3 (Least Preferred)

Initial Phase

Interval & Doses (minimal duration)

3x/wk for 24 doses (8 wks)

Continuation Phase

2 - Drug Combination Interval  & Doses (minimum duration)
Range of Total Doses (minimum duration)
INH/RIF 3x /wk for 54 doses (18 wks) 78 (26 wks)

Interval  & Doses (minimum duration)
When DOT is used, drugs may be given 5 days/week & the necessary number of doses adjusted accordingly
Patients with cavitation on initial CXR & positive cultures at completion of 2 months of therapy should receive a 7-month (31 weeks; either 217 doses {daily} or 62 doses {2x/week) continuation phase