TUBERCULOSIS TREATMENT GUIDELINES - 2003
Evidence-Based Guidelines for the Treatment of Adults with Drug
Susceptible Extrapulmonary Tuberculosis and
Adjunctive Use of Corticosteroids
AND
Dosing Recommendations for Adult Patients with Reduced Renal
Function and for Adult Patients Receiving Hemodialysis

Consultation to healthcare providers at 1-800-TEX-LUNG
2303 S.E. Military Drive, San Antonio, TX 78223
www.heartlandntbc.org

Table 13. Evidence-Based Guidelines for the Treatment of Adults with Drug-Susceptible Extrapulmonary Tuberculosis and Adjunctive Use of Corticosteroids

Site
Lymph Node (Although guidelines do not recommend steroids, some case series suggest benefit.)

Length of Therapy
6 months

Rating (Duration)
AI

Corticosteroids
Not Recommended

Rating (Corticosteroids)
DIII

Site
Bone and Joint

Length of Therapy
6 to 9 months

Rating (Duration)
AI

Corticosteroids
Not Recommended

Rating (Corticosteroids)
DIII

Site
Pleural Disease

Length of Therapy
6 months

Rating (Duration)
AII

Corticosteroids
Not Recommended

Rating (Corticosteroids)
DI

Site
Pericarditis

Length of Therapy
6 months

Rating (Duration)
AII

Corticosteroids
Strongly Recommended

Rating (Corticosteroids)
AI

Site
CNS Tuberculosis including Meningitis

Length of Therapy
9 to 12 months

Rating (Duration)
BII

Corticosteroids
Strongly Recommended

Rating (Corticosteroids)
AI

Site
Disseminated Disease

Length of Therapy
6 to 9 months

Rating (Duration)
AII

Corticosteroids
Not Recommended

Rating (Corticosteroids)
DIII

Site
Genitourinary (Although guidelines do not recommend steroids, some case series suggest benefit)

Length of Therapy
6 to 9 month

Rating (Duration)
AII

Corticosteroids
Not Recommended

Rating (Corticosteroids)
DIII

Site
Peritoneal (Although guidelines do not recommend steroids, some case series suggest benefit)

Length of Therapy
6 to 9 months

Rating (Duration)
AII

Corticosteroids
Not Recommended

Rating (Corticosteroids)
DIII

Produced by Heartland National TB Center.
Consultation to healthcare providers at 1-800-TEX-LUNG, www.HeartlandNTBC.org
This product produced with funds awarded by the Centers for Disease Control & Prevention (CDC).

Table 15. Dosing Recommendations for Adult Patients with Reduced Renal Function and For Adult
Patients Receiving Hemodialysis

Drug
Isoniazid

Change in Frequency
No change

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
300 mg once daily, or 900 mg three times/week

Drug
Rifampin

Change in Frequency
No change

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
600 mg once daily, or 600 mg three times/week

Drug
Pyrazinamide

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
25-35 mg/kg/dose three times/week (not daily)

Drug
Ethambutol

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
15-25 mg/kg/dose three times/week (not daily)

Drug
Levofloxacin

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
750-1000 mg/dose three times/week (not daily)

Drug
Cycloserine

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
250 mg once daily, or 500 mg/dose three times/week (The medications should be given after hemodiaylsis on the day of hemodialysis. *The appropriateness of 250 mg daily Cycloserine dose
has not been established. There should be careful monitoring or evidence of neurotoxicity. Monitoring of serum drug concentrations
should be considered)

Drug
Ethionamide

Change in Frequency
No Change

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
500 mg/dose daily

Drug
PAS

Change in Frequency
No Change

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
4 gm/dose twice daily

Drug
Streptomycin

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis

Drug
Capreomycin

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
12-15 mg/kg/dose two-three times/week (not daily)

Drug
Kanamycin

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
12-15 mg/kg/dose two-three times/week (not daily)

Drug
Amikacin

Change in Frequency
Yes

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
12-15 mg/kg/dose two-three times/week (not daily)

Drug
Moxifloxacin

Change in Frequency
No change

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
400 mg daily

Drug
Linezolid

Change in Frequency
No change

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
600 mg daily

Drug
Rifabutin

Change in Frequency
No change

Recommended Dose and Frequency for Patients with Creatinine Clearance less than 30 ml per minute or patients receiving Hemodialysis
Dose varies due to drug to drug interactions.