high

The 2HRZE/6HE treatment regimen should be phased out.

In patients treated with the regimen containing rifampicin throughout treatment, if a positive sputum smear is found at completion of the intensive phase,
the extension of the intensive phase is not recommended.

In previously treated patients, if the specimen obtained at the end of the intensive phase (month 3) is smear-positive, sputum culture and drug susceptibility
testing (DST) should be performed.

In new patients, if the specimen obtained at the end of month 3 is smear-positive,
sputum culture and drug susceptibility testing (DST) should be performed.

In new patients, if the specimen obtained at the end of the intensive phase
(month 2) is smear-positive, sputum smear microscopy should be obtained at
the end of the third month.

It is recommended that TB patients who are living with HIV should receive at least
the same duration of TB treatment as HIV-negative TB patients.

New patients with pulmonary TB should receive a regimen containing 6 months
of rifampicin: 2HRZE/4HR.

In adults and children with signs and symptoms of extrapulmonary TB, Xpert MTB/RIF or Xpert Ultra should be used for rifampicin-resistance detection rather than culture and phenotypic DST.

In adults with signs and symptoms of pulmonary TB and without a prior history of TB (≤5 years) or with a remote history of TB treatment (>5 years since end of treatment), Xpert Ultra should be used as an initial diagnostic test for TB and for rifampicin-resistance detection in sputum, rather than smear microscopy/culture and phenotypic DST.

Routine co-trimoxazole prophylaxis should be given to all HIV-infected patients with active TB
disease regardless of CD4 cell count.