RetourAlthough traditionally patients with DR-TB were hospitalized for portions of, and sometimes all of, their treatment, recommendations on this have changed. With the increasing use of all oral DR-TB treatment, patients with DR-TB should be treated whenever possible in an outpatient-based treatment programme similar to patients with DS-TB (60–62). Additionally, for both patients with DR-TB and those with DS-TB, treatment should move towards a decentralized, ambulatory care setting in order to make it easier for all patients to access medications and treatment support and for TB treatment to be less disruptive to their lives.
The following recommendations from WHO’s guidelines (15) apply to patients with DR-TB.
However, sometimes patients do require treatment in the hospital (inpatient). These may be patients with DR-TB, but they may also be patients with DS-TB with severe disease or treatment complications. The following discussion addresses some of the concerns regarding strategies for decentralized (outpatient/ambulatory) care models – which apply to majority of TB patients – and inpatient or hospital-based treatment for patients who need special treatment and care.