Table 2. PTB medical treatment in those with liver disease.
Concomitant immunocompromising conditions | Initial therapy | Continuation therapy | Comments |
No liver disease65 | 2 months of INH, RIF, PZA and EMB given dailyϕ | INH and RIF daily for at least an additional 4 months | |
No liver disease, HIV+ on antiretroviral therapy65 | 2 months of INH, RIF, PZA and EMB given daily | INH and RIF daily for at least an additional 4 months | As HIV patients are often on many additional medications, caution must be used when managing possible drug-drug interactions between HAART and TB therapy |
No liver disease, HIV+ not on antiretroviral therapy/ delayed response to therapy67 | 2 months of INH, RIF, PZA and EMB given daily | INH and RIF daily for at least an additional 7 months | |
Treatment failure70 | Revision of therapy with at least three unused medications with at a minimum one injectable agent while awaiting sensitivities | ||
Liver disease present 12 | RIF, PZA and EMB for 6 months | ||
INH, RIF, EMB for 2 months | followed by INH and RIF for another 7 months | ||
RIF, EMB, a fluoroquinolone, cycloserine/ injectable agents for 12–18 months | |||
SM, EMB, fluoroquinolone (e.g., moxifloxacin), and another second-line oral drug | Second-line agents: fluoroquinolones, rifabutin, ethionamide, amino salicylic acid, cycloserine |
While additional TB therapies have been found to be equally efficacious in cases of pulmonary disease, listed treatment regimens reflect those that have been trialed specifically in cases of abdominal tuberculosis.
Abbreviations: EMB, ethambutol; HAART, highly-active antiretroviral therapy; INH, isoniazid; PZA, pyrazinamide; RIF, rifampin; TB, tuberculosis.