title: Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.
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.
authors: Universityof California, San Francisco.
authors: Payam
authors: P
authors: Nahid
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Susan E
authors: SE
authors: Dorman
authors: Universityof California, San Francisco.
authors: Narges
authors: N
authors: Alipanah
authors: California Department of Public Health, Richmond.
authors: Pennan M
authors: PM
authors: Barry
authors: McMaster University, Hamilton, Ontario, Canada.
authors: Jan L
authors: JL
authors: Brozek
authors: Universityof California, San Francisco.
authors: Adithya
authors: A
authors: Cattamanchi
authors: Universityof California, San Francisco.
authors: Lelia H
authors: LH
authors: Chaisson
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Richard E
authors: RE
authors: Chaisson
authors: National Jewish Health, Denver, Colorado.
authors: Charles L
authors: CL
authors: Daley
authors: World Health Organization, Geneva, Switzerland.
authors: Malgosia
authors: M
authors: Grzemska
authors: Tuberculosis Control Section, San Francisco Department of Public Health, California.
authors: Julie M
authors: JM
authors: Higashi
authors: Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Christine S
authors: CS
authors: Ho
authors: Universityof California, San Francisco.
authors: Philip C
authors: PC
authors: Hopewell
authors: Harvard Medical School, Boston, Massachusetts.
authors: Salmaan A
authors: SA
authors: Keshavjee
authors: World Health Organization, Geneva, Switzerland.
authors: Christian
authors: C
authors: Lienhardt
authors: McGill University, Montreal, Quebec, Canada.
authors: Richard
authors: R
authors: Menzies
authors: Universityof California, San Francisco.
authors: Cynthia
authors: C
authors: Merrifield
authors: Tuberculosis Control Program, Seattle and King County Public Health, and University of Washington, Seattle.
authors: Masahiro
authors: M
authors: Narita
authors: Ethics Advisory Group, International Union Against TB and Lung Disease, Paris, France.
authors: Rick
authors: R
authors: O'Brien
authors: University of Florida, Gainesville.
authors: Charles A
authors: CA
authors: Peloquin
authors: Universityof California, San Francisco.
authors: Ann
authors: A
authors: Raftery
authors: Boston University, Massachusetts.
authors: Jussi
authors: J
authors: Saukkonen
authors: Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
authors: H Simon
authors: HS
authors: Schaaf
authors: University of Sassari, Italy.
authors: Giovanni
authors: G
authors: Sotgiu
authors: Baylor College of Medicine, Houston, Texas.
authors: Jeffrey R
authors: JR
authors: Starke
authors: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri Care and Research Institute, Tradate, Italy.
authors: Giovanni Battista
authors: GB
authors: Migliori
authors: Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Andrew
authors: A
authors: Vernon
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D015658:HIV Infections; D006801:Humans; D009169:Mycobacterium tuberculosis; D011634:Public Health; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents
keywords: HIV infections; Mycobacterium tuberculosis; antitubercular agents; case management; public health