Management of tuberculosis

Management of tuberculosis refers to techniques and procedures utilized for treating tuberculosis (TB), or simply a treatment plan for TB.

The medical standard for active TB is a short course treatment involving a combination of isoniazid, rifampicin (also known as Rifampin), pyrazinamide, and ethambutol for the first two months. During this initial period, Isoniazid is taken alongside pyridoxal phosphate to obviate peripheral neuropathy. Isoniazid is then taken concurrently with rifampicin for the remaining four months of treatment (6-8 months for miliary tuberculosis). A patient is expected to be free from all living TB bacteria after six months of therapy in Pulmonary TB or 8-10 months in Miliary TB.^{[citation needed]}

Latent tuberculosis or latent tuberculosis infection (LTBI) is treated with three to nine months of isoniazid alone. This long-term treatment often risks the development of hepatotoxicity. A combination of isoniazid plus rifampicin for a period of three to four months is shown to be an equally effective method for treating LTBI, while mitigating risks to hepatotoxicity. Treatment of LTBI is essential in preventing the spread of active TB.

All first-line anti-tuberculous drug names have semi-standardized three-letter and single-letter abbreviations:^{[citation needed]}

First-line anti-tuberculous drug names are often remembered with the mnemonic "RIPE", referring to the use of rifamycin (like rifampin), isoniazid, pyrazinamide, and ethambutol.^{[citation needed]}

In US practice, names and abbreviations that are not universally accepted are used. For example, rifampicin is referred to as rifampin and is abbreviated as RIF, while streptomycin is referred to as STM. The notations RIF, RFP, and RMP have all been frequently used for rifampicin, and the notations IRPE, HRZE, RIPE, and IREP for combination regimens are all synonyms or nearly synonyms depending on dosage schedules. Other abbreviations have also been widely used).^{[citation needed]}

In this system, which the World Health Organization (WHO) supports, "RIPE" is "RHZE". (Both have mnemonic potential, as tuberculosis is named after tubercles (small tubers), and a tuber can be ripe and can be a rhizome.)^{[medical citation needed]} This regimen is also known as "HREZ".

Drug regimens are similarly abbreviated in a semi standardized manner. The drugs are listed using their single letter abbreviations (in the order given above, which is roughly the order of introduction into clinical practice). A prefix denotes the number of months the treatment should be given for; a subscript denotes intermittent dosing (so ₃ means three times a week) and no subscript means daily dosing.^{[citation needed]}