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Concept
Tuberculosis management
Résumé
Tuberculosis management describes the techniques and procedures utilized for treating tuberculosis (TB).
The medical standard for active TB is a short course treatment involving a combination of isoniazid, rifampicin (also known as Rifampin), pyrazinamide, and ethambutol for the first two months. During this initial period, Isoniazid is taken alongside pyridoxal phosphate to obviate peripheral neuropathy. Isoniazid is then taken coincident with rifampicin for the remaining four months of treatment. A patient is considered free of all living TB bacteria after six months.
Latent tuberculosis or latent tuberculosis infection (LTBI) is treated with three to nine months of isoniazid alone. This long-term treatment often risks the development of hepatotoxicity. A combination of isoniazid plus rifampicin for a period of three to four months is shown to be an equally effective method for treating LTBI, while mitigating risks to hepatotoxicity. Treatment of LTBI is essential in preventing the spread of active TB.
All first-line anti-tuberculous drug names have semi-standardized three-letter and single-letter abbreviations:
ethambutol is EMB or E
isoniazid is INH or H
pyrazinamide is PZA or Z
rifampicin is RMP or R,
streptomycin is SM or S
First-line anti-tuberculous drug names are often remembered with the mnemonic "RIPE", referring to the use of rifamycin (like rifampin), isoniazid, pyrazinamide, and ethambutol.
In US practice, names and abbreviations that are not universally accepted are used. For example, rifampicin is referred to as rifampin and is abbreviated as RIF, while streptomycin is referred to as STM. The notations RIF, RFP, and RMP have all been frequently used for rifampicin, and the notations IRPE, HRZE, RIPE, and IREP for combination regimens are all synonyms or nearly synonyms depending on dosage schedules. Other abbreviations have also been widely used).
In this system, which the World Health Organization (WHO) supports, "RIPE" is "RHZE". (Both have mnemonic potential, as tuberculosis is named after tubercles (small tubers), and a tuber can be ripe and can be a rhizome.
Source officielle
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