Author in the Room: Update on Tuberculosis

June 2005 Author in the Room^® Teleconference

 

Author: Henry M. Blumberg, MD

 

Article: "Update on the Treatment of Tuberculosis and Latent Tuberculosis Infection"

 

Summary Points:

• Tuberculosis is a public health problem. The responsibility for prescribing an appropriate regimen and ensuring that treatment is completed is assigned to the public health program or the treating physician, not the patient.
• Directly observed therapy is recommended for all patients being treated for active TB. This will necessitate the need for greater collaboration between the treating physician and the public health department.
• Initial therapy for newly diagnosed patients with tuberculosis consists of a 4-drug regimen, including isoniazid, rifampin, pyrazinamide and ethambutol.
• Testing for latent TB infection should be targeted at those who are at increased risk of progression to active TB.
• Despite its limitations, the tuberculin skin test remains the most commonly used test for the diagnosis of latent TB infection; newer diagnostic tests for latent TB infection are on the horizon.
• Active tuberculosis should be excluded before beginning treatment for latent tuberculosis infection.
• Nine months of isoniazid is the preferred therapy for the treatment of latent TB infection.