- Directly Observed Treatment Short Course (DOTS)
Used in new Pulmonary TB smear positive patients; new Pulmonary TB smear negative and Extrapulmonary TB patients who are seriously ill; TB in children < 6 years. It consists of 8 weeks of treatment with Streptomycin, Rifampicin, Isoniazid and Pyrazinamide during the intensive phase followed by 6 monthes of Ethambutol and Isoniazid or 4 months of rifampin and isoniazid (RH). (2S (RHZ)/6(EH). Children <6 years receive 4 monthes of Rifampicin and INH (RH) in the continuation phase. Drugs have to be collected daily during the intensive phase of DOTS and taken under direct observation by the health worker. During the continuation phase drugs have to be collected every month and self-administered by the patient.
- Re- treatment Regimen
Used for patients previously treated for more than one month with short course chemotherapy (SCC) and Long course chemotherapy (LCC) and are still smear positive. These patients are: – Relapses; Treatment failures; Returns after default who are pulmonary tuberculosis positive. It consists of 2 months of treatment using Streptomycin, INH, Ethambutol, Rifampicin and Pyrazinamide then 1month of INH, Ethambutol, Rifampicin and Pyrazinamide in the intensive phase, Followed by 5 months of ethambutol, Rifampicin and INH. [2SE (RH) Z/1E (RH) Z/5E3 (RH) 3]. (Streptomycin should not be included in the retreatment regimen for pregnant women). The drugs should be taken under direct observation of the health worker throughout the duration of Retreatment including the continuation phase.
- Short course Chemotherapy
Is recommended for new patients with smear negative pulmonary TB, new patients with extra pulmonary tuberculosis and TB in children of 6 years and older. It consists of 8 weeks of treatment with Rifampicin, Isoniazid and Pyrazinamide during the intensive phase followed by 6 months of Ethambutol and Isoniazid. [2(RHZ)/6(EH)].
- Long course chemotherapy (LCC)
Is to be prescribed in all cases of TB in regions/Zones where the DOTS program is not yet started. 2 months of Streptomycin, Ethambutol and INH in the intensive phase followed by 10 months of Ethambutol and INH.
Second-line antitubercular drugs include ethionamide, para-aminosalicylic acid, capreomycin, cycloserine, amikacin, ciprofloxacin, etc. These agents are considered during failure of clinical response to first-line drugs under supervision of their adverse effects.
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