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U.S. Department of Health and Human Services

  

Core Curriculum on Tuberculosis, 2000

Chapter 7
Treatment of TB Disease

Persons with Additional Medical Problems

A number of medical conditions may alter immune responsiveness and predispose a person to TB. Such disorders include HIV infection, immunosuppressive therapy, hematologic or reticuloendothelial malignancies, chronic renal failure, diabetes, and malnutrition. These conditions may influence the outcome of therapy. Therapeutic decisions for the impaired host must be individualized.

Patients with partial impairment of renal function should avoid streptomycin, kanamycin, and capreomycin if possible. If renal function is severely impaired, reduced doses or increased dosing intervals of other TB drugs may be necessary (see table 7). Measurement of drug serum levels may be helpful in adjusting the dosage.

For patients who abuse alcohol or who have neuropsychiatric disorders, close supervision preferably using DOT is necessary to ensure adherence and to monitor for adverse reactions to medications.

 


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination - http://www.cdc.gov/tb

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