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Recent changes in Tuberculosis guidelines 2016

Based on RNTCP guidelines 2016.

1. 3 new goals – cure, prevent resistance and break chain of transmission.
2. Introduction of daily regime
3. Definition and treatment of mono and polyresistance apart from MDR and XDR Tuberculosis
4. Treatment in CAT 1 – 2(HRZE) + 4 (HRE) : Continue ethambutol in continuation phase too 
5. Treatment in CAT 2 – 2(HRZES) + 1(HRZE) + 5 (HRE)
6. Introduction of Bedaquiline as a new drug. ATP synthase inhibitor specifically targets myc. Tb. Indicated in age more than 18 years. Contraindicatef in pregnancy and those taking hormonal OCP. It may be given in patients with stable arrythmia.
7. Definition of presumptive tuberculosis. Duration > 2 weeks etc
8. New algorithm to diagnose Tuberculosis – pulmonary, extrapulmonary, drug resistant.
9. Introduction of Newer molecular methods like CBNAAT and line probe assay in diagnostic algorithm apart from smear microscopy and chest Xray.
10. Diagnosis of tuberculosis based on X-ray will be called as Clinically diagnosed tuberculosis
11. Sputum should be around 2ml and preferably be mucopurulent.
12. Follow up – New and previously treated Drug sensitive pulmonary tuberculosis – No need to extend Intensive phase, sputum microscopy at end of IP and end of treatment, weight monthly, chest x-ray if required.
13. Follow up – MDR tuberculosis – sputum smear monthly 3,4,5,6,7 months in intensive phase and at 3 months interval in continuation phase 9,12,15..., extend ip phase by maximum 3 months total of 9 months.











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9 comments:

Anonymous said...

Kindly mention the Source of this information

Pratyush kumar said...

This is based on recent RNTCP guidelines. Links of which is given in my previous posts.

Dr c b rohitas said...

Thanks for the guidelines.

Unknown said...

Thanks for wonderful blog. Very confident blog. From where to get CBNAAT facility is it available at RNTCP centres.

Unknown said...

Thanks for wonderful blog. Very confident blog. From where to get CBNAAT facility is it available at RNTCP centres.

Pratyush kumar said...

thank you. RNTCP centres are equipped to do it, or they can send the samples to appropriate labs of RNTCP.

Unknown said...

Is there changes in frequency dose of Intensive phase
Daily admistreted instead of thrice weekly?

Pratyush kumar said...

Yes..Earlier in dots regime there was alternate day regimen.with recent change its now daily regimen.

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