Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis

被引：750

作者：

Nahid, Payam ^{[1
]}

Dorman, Susan E. ^{[2
]}

Alipanah, Narges ^{[1
]}

Barry, Pennan M. ^{[3
]}

Brozek, Jan L. ^{[4
]}

Cattamanchi, Adithya ^{[1
]}

Chaisson, Lelia H. ^{[1
]}

Chaisson, Richard E. ^{[2
]}

Daley, Charles L. ^{[5
]}

Grzemska, Malgosia ^{[6
]}

Higashi, Julie M. ^{[7
]}

Ho, Christine S. ^{[8
]}

Hopewell, Philip C. ^{[1
]}

Keshavjee, Salmaan A. ^{[9
]}

Lienhardt, Christian ^{[6
]}

Menzies, Richard ^{[10
]}

Merrifield, Cynthia ^{[1
]}

Narita, Masahiro ^{[12
,13
]}

O'Brien, Rick ^{[14
]}

Peloquin, Charles A. ^{[15
]}

Raftery, Ann ^{[1
]}

Saukkonen, Jussi ^{[16
]}

Schaaf, H. Simon ^{[17
]}

Sotgiu, Giovanni ^{[18
]}

Starke, Jeffrey R. ^{[19
]}

Migliori, Giovanni Battista ^{[11
]}

Vernon, Andrew ^{[8
]}

机构：

[1] Univ Calif San Francisco, San Francisco, CA 94110 USA

[2] Johns Hopkins Univ, Baltimore, MD USA

[3] Calif Dept Publ Hlth, Richmond, CA USA

[4] McMaster Univ, Hamilton, ON, Canada

[5] Natl Jewish Hlth, Denver, CO USA

[6] WHO, Geneva, Switzerland

[7] San Francisco Dept Publ Hlth, TB Control Sect, San Francisco, CA USA

[8] Ctr Dis Control & Prevent, Div TB Eliminat, Natl Ctr HIV AIDS Viral Hepatitis STD & TB Preven, Atlanta, GA USA

[9] Harvard Med Sch, Boston, MA USA

[10] McGill Univ, Montreal, PQ, Canada

[11] Fdn S Maugeri Care & Res Inst, WHO Collaborating Ctr TB & Lung Dis, Tradate, Italy

[12] Seattle & King Cty Publ Hlth, TB Control Program, Seattle, WA USA

[13] Univ Washington, Seattle, WA 98195 USA

[14] Int Union TB & Lung Dis, Eth Advisory Grp, Paris, France

[15] Univ Florida, Gainesville, FL USA

[16] Boston Univ, Boston, MA 02215 USA

[17] Univ Stellenbosch, Dept Paediat & Child Hlth, Cape Town, South Africa

[18] Univ Sassari, Sassari, Italy

[19] Baylor Coll Med, Houston, TX 77030 USA

来源：

CLINICAL INFECTIOUS DISEASES | 2016年 / 63卷 / 07期

关键词：

Mycobacterium tuberculosis; HIV infections; antitubercular agents; case management; public health;

D O I：

10.1093/cid/ciw376

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

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.

引用

页码：e147 / e195

页数：49

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