New tb regimen 2019

In 2019, the World Health Organization (WHO) updated its guidelines for the treatment of tuberculosis (TB), introducing a new regimen for the treatment of drug-susceptible TB. The new regimen is known as the "WHO-recommended TB regimen" or "2019 WHO TB regimen".

The key changes in the new regimen are:

1. Shorter treatment duration: The new regimen reduces the treatment duration from 6-8 months to 4-6 months for most patients.
2. Fewer medications: The regimen reduces the number of medications from 6-8 to 4-5.
3. Isoniazid (H) and rifampicin (R): These two medications remain the core of the regimen, but with some changes in dosing and duration.
4. Pyrazinamide (Z): This medication is added to the regimen for the first 2 months to improve treatment outcomes.
5. Ethambutol (E): This medication is added to the regimen for patients with a high risk of resistance to isoniazid or rifampicin.
6. Corticosteroids: The regimen recommends the use of corticosteroids for patients with severe TB-related symptoms, such as severe cough, chest pain, or difficulty breathing.

The 2019 WHO TB regimen is as follows:

Regimen for adults and children ≥10 years old

• Month 1-2: H (300 mg) + R (450 mg) + Z (1,500 mg) + E (15-20 mg/kg)
• Month 3-4: H (300 mg) + R (450 mg) + E (15-20 mg/kg)
• Month 5-6: H (300 mg) + R (450 mg)

Regimen for children <10 years old

• Month 1-2: H (10-20 mg/kg) + R (10-20 mg/kg) + Z (20-30 mg/kg) + E (10-15 mg/kg)
• Month 3-4: H (10-20 mg/kg) + R (10-20 mg/kg) + E (10-15 mg/kg)
• Month 5-6: H (10-20 mg/kg) + R (10-20 mg/kg)

Additional considerations

• Patients with a high risk of resistance to isoniazid or rifampicin should receive E (15-20 mg/kg) throughout the treatment duration.
• Patients with severe TB-related symptoms should receive corticosteroids (prednisone 40-60 mg/day) for the first 2 months.
• Patients with HIV-TB coinfection should receive antiretroviral therapy (ART) in addition to the TB regimen.

It's essential to note that the 2019 WHO TB regimen is a general guideline, and treatment decisions should be made on a case-by-case basis, taking into account individual patient characteristics, treatment history, and resistance patterns.