tuberculosis%20-%20pulmonary
TUBERCULOSIS - PULMONARY
Treatment Guideline Chart
Tuberculosis (TB) suspect is any one who has signs or symptoms suggestive of TB (eg >2 weeks productive cough).
Definite TB is considered in patients with culture or molecular line probe assay positive for Mycobacterium tuberculosis, or in patients with at least 1 sputum smear positive for acid-fast bacilli.
TB cases are also classified based on the disease anatomical site, bacteriological results (including drug resistance), previous treatment history and patient's HIV status.
Pulmonary TB is a case of TB that involves the lung parenchyma.
Miliary TB is considered as PTB since lung lesions are also seen.
TB in the pleural effusion, mediastinal and/or hilar lymph nodes with no evidence of abnormalities in the chest x-ray are considered extrapulmonary TB.
Patients presenting with both PTB and extrapulmonary TB are classified as a case of PTB.

Tuberculosis - Pulmonary References

  1. American Thoracic Society. Diagnostic Standards and Classification of Tuberculosis in Adults and Children. Am J Respir Crit Care Med. 2000 Apr;161(4)(Suppl Pt 1):1376-1395. http://www.atsjournals.org/doi/pdf/10.1164/ajrccm.161.4.16141. PMID: 10764337
  2. American Thoracic Society, CDC; Infectious Diseases Society of America. Treatment of tuberculosis. MMWR. 2003 Jun;52:1-77. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm. PMID: 12836625
  3. Joint Tuberculosis Committee of the British Thoracic Society. BTS guidelines: chemotherapy and management of tuberculosis in the United Kingdom: recommendations 1998. Thorax. 1998 Jul;53(7):536-548. http://thorax.bmj.com/content/53/7/536.full.pdf+html. PMID: 9797751
  4. Horsburgh CB, Feldman S, Ridzon R. Guidelines from the Infectious Diseases Society of America. Oct 04, 2000. Clin Infect Dis. 2000 Sep;31(3):633-639. http://cid.oxfordjournals.org/content/31/3/633.full.pdf. PMID: 11017808
  5. Marais BJ, Gie RP, Schaaf HS, et al. Childhood pulmonary tuberculosis: old wisdom and new challenges. Am J Respir Crit Care Med. 2006 May;173(10):1078-1090. PMID: 16484674
  6. American Thoracic Society, CDC; Infectious Diseases Society of America. Treatment of tuberculosis. MMWR. 2003 Jun;52:001-88. PMID: 10764337
  7. Newton SM, Brent AJ, Anderson S, et al. Paediatric tuberculosis. Lancet Infect Dis. 2008 Aug;8(8):498-510. PMID: 18652996
  8. Department of Health (HKSAR), Centre for Health Protection Department of Health (HKSAR), Centre for Health Protection. Tuberculosis manual; 2006. www.info.gov.hk/tb_chest/doc/Tuberculosis_Manual2006.pdf. Accessed 21 Nov 2006
  9. Gilbert DN, Moellering RC, Eliopoulos GM, et al. The Sanford guide to antimicrobial therapy. 40th. Sperryville, VA: Antimicrobial Therapy Inc; 2010.
  10. Lu-Fong MT, How CH, et al. Tuberculosis in infancy and childhood. In: Committee on Handbook on Childhood Tuberculosis of the Philippine Pediatric Society. Handbook on Childhood Tuberculosis of the Philippine Pediatric Society. 2nd ed. Manila, Philippines: Philippine Pediatric Society Inc; 2003
  11. Crofton J, Chaulet P, Mahar D, et al. Guidelines for the management of drug-resistant tuberculosis: World Health Organization; 1997
  12. Department of Health (HKSAR). Tuberculosis Manual: Hong Kong SAR; 2006
  13. Starke JR. Tuberculosis (Mycobacterium tuberculosis). In: Kliegman RM, Stanton BF, St Geme JW III, et al, eds. Nelson textbook of Pediatrics. 19th ed. Philadelphia: Saunders, Elsevier; 2011
  14. The Lung Association Tuberculosis Committee. Tuberculosis: information for health care provider. 3rd ed. Canada: The Lung Association; 2003
  15. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  16. MedWormhttp://www.medworm.com/rss/index.php/Respiratory-Medicine/40/http://www.medworm.com/rss/medicalfeeds/specialities/Respiratory-Medicine.xml
  17. Ambulatory treatment and public health measures for apatient with uncomplicated pulmonary tuberculosis (Update 2004). Internal guidelines of the Tuberculosis & Chest Service of the Department of Health of the Government of the Hong Kong SAR. CHP. http://www.chp.gov.hk/files/pdf/grp-AmbulatoryRx0402-en-2004052100.pdf. 2004
  18. World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. http://whqlibdoc.who.int/hq/2006/WHO_HTM_TB_2006.371_eng.pdf. 2006
  19. Long R, Ellis E, et al for Tuberculosis Prevention and Control, Public Health of Canada, and the Canadian Lung Association/Canadian Thoracic Society. Canadian tuberculosis standards. 6th ed. http://www.phac-aspc.gc.ca/tbpc-latb/pubs/pdf/tbstand07_e.pdf. 2007. Accessed 08 Jun 2011
  20. Tuberculosis Coalition for Technical Assistance. International standards for tuberculosis care (ISTC). 2nd ed. http://www.istcweb.org/documents/ISTC_Report_2ndEd_Nov2009.pdf. 2009. Accessed 07 Jun 2011
  21. Crofton J, Chaulet P, Mahar D, et al. Guidelines for the management of drug-resistant tuberculosis. WHO. 1997
  22. Medical Consensus Development Panel, Academy of Medicine Malaysia. Guidelines on the management of tuberculosis. http://www.acadmed.org.my/cpg/management of_tuberculosis.htm. 2004. Accessed 20 Jul 2004
  23. Ministry of Health Malaysia. Academy of Medicine Malaysia. Malaysian Thoracic Society. Management of tuberculosis (3rd edition). http://www.acadmed.org.my. Nov 2012. Accessed 05 Aug 2013
  24. Ministry of Health Malaysia, Academy of Medicine of Malaysia. Practice guidelines for the control and management of tuberculosis. http://www.moh.gov.my/. 2006
  25. Task Force on Tuberculosis, Philippine Practice Guidelines Group in Infectious Diseases. Pulmonary tuberculosis: clinical practice guidelines. PPGG-ID Philippine Society for Microbiology and Infectious Diseases and Philippine College of Chest Physicians. http://tailieu.vn/doc/the-philippine-clinical-practice-guidelines-on-the-diagnosis-treatment-and-control-of-pulmonary-tub.1338507.html. 2000
  26. Ministry of Health Singapore. Tuberculosis. MOH (Singapore). http://2012.http://www.moh.gov.sg/content/moh_web/home/diseases_and_conditions/t/tuberculosis.html. Jan 2012. Accessed 05 Aug 2013
  27. World Health Organization. Rapid advice: treatment of tuberculosis in children. http://whqlibdoc.who.int/publications/2010/9789241500449_eng.pdf. 2010. Accessed 25 Nov 2011
  28. Centers for Disease Control and Prevention. TB elimination - tuberculin skin testing. http://www.cdc.gov/tb/publications/factsheets/testing/skintesting.pdf. Oct 2011. Accessed 09 Dec 2011
  29. National Institute for Health and Care Excellence (NICE). Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control. National Institute for Health and Care Excellence (NICE). http://www.nice.org.uk/guidance/cg117/resources/guidance-tuberculosis-pdf. Mar 2011. Accessed 06 Sep 2014.
  30. World Health Organization. Definitions and reporting framework for tuberculosis – 2013 revision. http://apps.who.int/iris/bitstream/10665/79199/1/9789241505345_eng.pdf. 2013. Accessed 06 Sep 2014.
  31. World Health Organization. Treatment of tuberculosis: guidelines for national programmes. 4th ed. World Health Organization. http://whqlibdoc.who.int/publications/2010/9789241547833_eng.pdf?ua=1. 2010. Accessed 06 Sep 2014.
  32. Centers for Disease Control and Prevention. Provisional CDC guidelines for the use and safety monitoring of bedaquiline fumarate (Sirturo) for the treatment of multidrug-resistant tuberculosis. MMWR Recomm Rep. 2013 Oct;62(RR-09):1-12. http://www.cdc.gov/mmwr/pdf/rr/rr6209.pdf. PMID: 24157696
  33. Gilbert DN, Moellering RC, Eliopoulos GM, et al. The Sanford guide to antimicrobial therapy. 40th ed. Sperryville, VA: Antimicrobial Therapy Inc ; 2010.
  34. Stop TB Department of the World Health Organization. Treatment of tuberculosis: guidelines for national programmes. 3rd ed. Geneva: World Health Organization; 2003.
  35. TB CARE I. International standards for tuberculosis care. 3rd ed. World Health Organization. http://www.who.int/tb/publications/ISTC_3rdEd.pdf.. 2014. Accessed 17 Jul 2014.
  36. World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. 2nd ed. World Health Organization. http://apps.who.int/iris/bitstream/10665/112360/1/9789241548748_eng.pdf?ua=1&ua=1. 2014. Accessed 17 Jul 2014.
  37. World Health Organization. Systematic screening for active tuberculosis: principles and recommendations. World Health Organization website. http://apps.who.int/iris/bitstream/10665/84971/1/9789241548601_eng.pdf?ua=1. 2013.
  38. Adams LV, Starke JR. Tuberculosis disease in children. UpToDate. http://www.uptodate.com. 2018.
  39. Borisov AS, Bamrah Morris S, Njie GJ, et al. Update of recommendations for use of once-weekly Isoniazid-Rifapentine regimen to treat latent Mycobacterium tuberculosis infection. MMWR Morb Mortal Wkly Rep. 2018 Jun;67(25):723-726. doi: 10.15585/mmwr.mm6725a5. PMID: 29953429
  40. ClinicalKey. Tuberculosis. ClinicalKey. https://www.clinicalkey.com. 2018.
  41. Drew RH, Sterling TR. Antituberculous drugs: An overview. UpToDate. https://www.uptodate.com. 2018.
  42. Hologic, Inc. Amplified Mycobacterium tuberculosis direct test. Hologic. https://www.hologic.com. 2017. Accessed 4 Feb 2019.
  43. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: Diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017 Jan;64(2):e1-e33. doi: 10.1093/cid/ciw694. Accessed 4 Feb 2019
  44. World Health Organization. Companion handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis. World Health Organization. https://www.who.int. 2014.
  45. World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. World Health Organization. https://www.who.int. 2014.
  46. World Health Organization. Guidelines for treatment of drug-susceptible tuberculosis and patient care. World Health Organization. https://www.who.int. 2017.
  47. World Health Organization. WHO treatment guidelines for drug-resistant tuberculosis. World Health Organization. https://www.who.int. Oct 2016. Accessed 4 Feb 2019.
  48. Bernardo J. Diagnosis of pulmonary tuberculosis in adults. UpToDate. https://www.uptodate.com. 12 Dec 2019.
  49. Nahid P, Mase SR, Migliori GB, et al. Treatment of drug-resistant tuberculosis: an official ATS/CDC/ERS/IDSA clinical practice guideline. Am J Respir Crit Care Med. 2019 Nov;200(10):e93-e142. doi: 10.1164/rccm.201909-1874ST. PMID: 31729908
  50. Schluger NW, Heysell SK, Friedland G. Treatment of drug-resistant pulmonary tuberculosis in adults. UpToDate. https://www.uptodate.com. 30 Jun 2020.
  51. Sterling TR. Treatment of drug-susceptible pulmonary tuberculosis in HIV-uninfected adults. UpToDate. https://www.uptodate.com. 27 Apr 2020.
  52. Sterling TR, Njie G, Zenner D, et al. Guidelines for the treatment of latent tuberculosis infection: recommendations from the National Tuberculosis Controllers Association and CDC 2020. MMWR Recomm Rep. 2020 Feb;69(No. RR-1):1-11. http://dx.doi.org/10.15585/mmwr.rr6901a1. . Accessed 28 Jul 2020
  53. World Health Organization (WHO). WHO consolidated guidelines on tuberculosis. Module 3: diagnosis – rapid diagnostics for tuberculosis detection. WHO. https://www.who.int/. 2020.
  54. World Health Organization WHO). WHO consolidated guidelines on tuberculosis. Module 4: treatment – drug-resistant tuberculosis treatment. WHO. https://www.who.int/. 2020.
  55. World Health Organization (WHO). WHO operational handbook on tuberculosis. Module 1: prevention – tuberculosis preventive treatment. WHO. https://www.who.int/. 2020.
  56. World Health Organization (WHO). WHO operational handbook on tuberculosis. Module 4: treatment – drug-resistant tuberculosis treatment. WHO. https://www.who.int/. 2020.
  57. Carr W, Kurbatova E, Starks A, et al. Interim Guidance: 4-Month Rifapentine-Moxifloxacin regimen for the treatment of drug-susceptible pulmonary tuberculosis — United States, 2022. MMWR Morb Mortal Wkly Rep. 2022;71:285-289. http://dx.doi.org/10.15585/mmwr.mm7108a1.
  58. World Health Organization (WHO). Global tuberculosis report 2021. WHO. https://www.who.int/. 2021.
  59. World Health Organization (WHO). WHO consolidated guidelines on tuberculosis. Module 3: diagnosis - rapid diagnostics for tuberculosis detection 2021 update. WHO. https://www.who.int/. 2021.
  60. World Health Organization (WHO). WHO consolidated guidelines on tuberculosis. Module 4: treatment – drug-resistant tuberculosis treatment. WHO. https://www.who.int/. 2021.
  61. Department of Health (DOH). National Tuberculosis Control Program Manual of procedures 6th edition. DOH. https://ntp.doh.gov.ph/.
  62. World Health Organization (WHO). WHO consolidated guidelines on tuberculosis. Module 4: treatment – drug-susceptible tuberculosis treatment. WHO. https://www.who.int/. 2022.
  63. World Health Organization (WHO). WHO operational handbook on tuberculosis. Module 4: treatment – drug-susceptible tuberculosis treatment. WHO. https://www.who.int/. 2022.
Editor's Recommendations
Special Reports