Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

TB Medication Dose Monitoring
Regimen 1*
Name:_________________________________ DOB ____/_____/_______ Start Date ____/_____/_______
Location:______________________________________ PHN:____________________________________
Expected End of Treatment Date:_______________________________
Initial Phase – Option 1
INH, RIF, PZA, EMB 7 days/week for 56 doses or 5 days/week for 40 doses (8 weeks)
Total: _______
Continuation Phase – Option 1a
INH, RIF 7 days/week for 126 doses or 5 days/week for 90 doses (18 weeks)
Total: _______
Option 1b
INH, RIF Twice weekly for 36 doses (18 weeks)
Approved for: HIV+ CD4 count must >100 cells
* CDC. Treatment of Tuberculosis, ATS, CDC and Infectious Diseases Society of America. MMWR 2003;52 / (No. RR-11):[3] 18.23
Total: _______
**Additional doses
Option 1a: Patient with cavitation on initial chest radiograph and + cultures at 2 months of therapy should extend treatment for 3 additional months
(13 weeks = 65 additional daily doses with 5 day/week dosing).
Option 1b: Patient with cavitation on initial chest radiograph and + cultures at 2 months of therapy should extend treatment for 3 additional months
(13 weeks = 26 additional twice-weekly doses).
INH, RIF Twice weekly for 26 doses or 5 days/week for 65 doses (13 weeks)
Total: _______
Notes:
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Rev 11/12