The result of a consensus conference American College of Chest Physician 1984 about tuberculosis has been announced. Chemotherapy treatments were as follows :
- Duration of treatment is 9 months with a combination of INH and rifampin, sometimes combined with ethambutol, streptomycin, or pyrazinamide.
- Baby, children, adults should get INH or rifampin, coupled with other similar drugs when there is suspected drug resistance.
- When there is suspicion of drug resistance, then at least 3 kinds of drugs should be given early treatment.
- Treatment less than 6 months, it is not enough. May be done during 6 months, but in strict control and in the first 2 months should be given INH, rifampin, pyrazinamide and streptomycin or ethambutol. then continue with INH or rifampin for 4 months.
- Examination of drug sensitivity needs to be done at the beginning of treatment, this needs to be done when there is suspicion of drug resistance.
- In pregnancy, treatment must take place within 9 months with INH or rifampin and ethambutol in the first 2 months. Streptomycin and pyrazinamide should not be given during pregnancy.
- Patients which receiving immuno suppressive treatment should be given regular therapy for 9-12 months.
- Ekstrapulmonar tuberculosis should be treated the same way.
Prevention :
- Contact with the case in the treatment can be given INH for 9 months, although the picture of the chest looks normal.
- Those aged more than 35 years, liver function should be monitored against transaminase test in first month, 3rd, 6th and 9th. This inspection does not replace thorough clinical examination.
- For instance, who got an infection with bacteria that are resistant to INH, then it could be given rifampin for 1 year.
- Those who have high risk, can be considered to be given high doses of INH two times a week.
(Wiseman MD, Sbarbaro JA : Consensus statements. Arch. Intern. Med. 1985;145:630-1)
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