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Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis

Nahid, Payam, Dorman, Susan E., Alipanah, Narges, Barry, Pennan M., Brozek, Jan L., Cattamanchi, Adithya, Chaisson, Lelia H., Chaisson, Richard E., Daley, Charles L., Grzemska, Malgosia, Higashi, Julie M., Ho, Christine S., Hopewell, Philip C., Keshavjee, Salmaan A., Lienhardt, Christian, Menzies, Richard, Merrifield, Cynthia, Narita, Masahiro, O'Brien, Rick, Peloquin, Charles A., Raftery, Ann, Saukkonen, Jussi, Schaaf, H. Simon, Sotgiu, Giovanni, Starke, Jeffrey R., Migliori, Giovanni Battista, Vernon, Andrew·2016·Clinical Infectious Diseases
DOI 10.1093/cid/ciw376
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Abstract

The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the component drugs, optimal management of tuberculosis in special populations, identification of accurate biomarkers of treatment effect, and the assessment of new strategies for implementing regimens in the field remain key priority areas for research. See the full-text online version of the document for detailed discussion of the management of tuberculosis and recommendations for practice.

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200 of 506 shown

Cited by

Metadata

Authors
Nahid, P., Dorman, S. E., Alipanah, N., Barry, P. M., Brozek, J. L., Cattamanchi, A., Chaisson, L. H., Chaisson, R. E., Daley, C. L., Grzemska, M., Higashi, J. M., Ho, C. S., Hopewell, P. C., Keshavjee, S. A., Lienhardt, C., Menzies, R., Merrifield, C., Narita, M., O'Brien, R., Peloquin, C. A., Raftery, A., Saukkonen, J., Schaaf, H. S., Sotgiu, G., Starke, J. R., Migliori, G. B., & Vernon, A.
Affiliations
  • University 1     , San Francisco
  • Johns Hopkins University 2   , Baltimore, Maryland
  • 3  California Department of Public Health, Richmond
  • McMaster University 4   , Hamilton, Ontario , Canada
  • National Jewish Health 5   , Denver, Colorado
  • World Health Organization 6   , Geneva , Switzerland
  • Tuberculosis Control Section 7   , San Francisco Department of Public Health, California
  • National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention 8   Division of Tuberculosis Elimination , , Atlanta, Georgia
  • Harvard Medical School 9   , Boston, Massachusetts
  • McGill University 10   , Montreal, Quebec , Canada
  • Tuberculosis Control Program, Seattle and King County Public Health, and University of Washington 12   , Seattle
  • International Union Against TB and Lung Disease 13   Ethics Advisory Group , , Paris , France
  • University of Florida 14   , Gainesville
  • Boston University 15   , Massachusetts
  • 16  Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
  • University of Sassari 17   , Italy
  • Baylor College of Medicine 18   , Houston, Texas
  • 11  WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri Care and Research Institute, Tradate, Italy
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2016-08-10
Volume
63
Issue
7
Pages
e147-e195
ISSN
  • 1537-6591
  • 1058-4838
DOI
10.1093/cid/ciw376
Cited by
1,170
References
7
Language
en
Funders
  • American Thoracic Society
  • IDSA
  • CDC
  • NIH

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