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ciw376

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 s for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible TuberculosisPa

ram Nahĩđ.' Susan E Dorman,2 Names AJipanah.' Pennan M. Barry? Jan L Brozek.’ Adithya Cattamanchi,’ Lelia H Chaisson,' Richard E. Chaisson? Charles L ciw376

Daley.1 Malgosia Grzeiiiska? Julie M Higashi,’ Climline s. Ho.’ Philip c. Hopewell.' Salinaan A. Kesharjee.’ Christian Lienhardt?Richard Menzies." Cyn

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thia Merrifield,’ Masahiro Narita,12 Rick O'Brien.” Charles A. Peloquin.” Ann Raftery,' Jussi Saukkonen.’’ H Simon Schaaf." Giovanni Solgiu,” Jeffrey

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 á ữtpđỉHHii ul Putin; Hetftli. RMbmonl. ‘Md/urlcr Utwiiily. Hmrltui. Ontario. CatoJa. ;H:hm.1 Jnwttfi Hnahn. Orrrvrr. Cotoradi; aAot(t HesTth ftcrrahr

n. íỉcnera. Swrtmrlms: 'Tufmriints CmtTtt Sertm. San fanctKO Orp.-rt-.crt cf hiNk tterltr. Catfnrri.T ’Ormnn cf kbemitais Flmnaina. Natoml Crntrr hr H ciw376

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Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 d lutij Uiswre. Patil, han*. ’Xlnwnffycf finr.ito. farcnik; ’’fttttm Umcnity. ktesfahBRSr: ’’OcportiHM nt PxtiMK! .-nd Chid Health. Stnin-hxrti Unxfar

tity. Cape Twin Sn:thAfnr.i ’llrnnsiry of Sasun, fctf and ’’Rrykx College nt Medline; Hailfan. TrxnThe American Thoracic Society, Centers tor Disease ciw376

Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug susce

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ptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representati

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 ld Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public healt

h management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, a ciw376

nd radiographic, studies, among other diagnostic tools, are available on a routine basis. For all recommendations. literature reviews were pet formed,

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followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 tuations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities. severity of disease, and response to

treatment influence management decisions. Specific recommendations on the use of case management strategics (including directly observed therapy), re ciw376

gimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tub

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erculosis treatment and liming of initiation of antiretroviral therapy), as well as treatment of extrap ulmonary disease (central nervous system, peri

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 onent drugs, optimal management of tuberculosis in special populations, identification of accurate hiomarkers of treatment effect, and the assessment

of new strategies for implementing regi mens in the field remain key priority areas for research. Sec the full-text online version of the document for ciw376

detailed discussion of the management of tuberculosis and recommendations for practice.Keywords. MyotbMterium tuberculosis.-, HIV infections; antituh

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ercular agents; case management; public health.Rtfaemd '1 J-IK 2016. arrested 6 Jme 2016, lubidfad mine 10 Auuict 2016.There MuiWirra eiUirreO br tie

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 r ndwrtirt wn.rnn ;rr>-.r>j pmmtx Thrty ,w nrf irmntol to aifplim phyâcÌMi lulaiKtil wth rcriKCt to txrtvds patients ut ^eoal clntsl stustims. Ire :p;

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de by tt»- ptiprian in me Iqtr nt each [Whfnti iraltifaiBl 0

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Hur-prtsl, Piitrorury aid ũ:t>cal Cme Medóne; 1001 IbliETO fue. SCI. San ItMKirco. Cft 91110 IpníhOíbxĩíMulClinical Infection Diseases* 2016ii7)--e147

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 sanmCuupcan DOI. 1O.109Wddtow378EXECUTIVE SUMMARYThe American Ì horacic Society (ATS), Centers for Disease Control and Prevention (CDC), and Infectiou

s Diseases Society of America (IDSA) jointly sponsored the development of this guideline on the treatment of drug susceptible tuberculosis, which IS a ciw376

lso endorsed by the European Respiratory Society (ERS) and the US National Tuberculosis Controllers Association (NTCA). This guideline provides recomm

ciw376

endations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecularDo

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 Susceptible TB • CID 2016:6} (1 October) • e!47Tabic 1. Interpretation of ’Strong" and 'Conditional' Grading of Recommendations Assessment Development

, and Evaluation-Based RecommendationsImplications for:Strong flccommcndatKinCorxtitonal RecommendationPatientsMeet indviduats in ths situation would ciw376

wont the rcccrrmended cocrse of action. and onya small proportion wood mtThe mạo-ity of indr.td.ials in the situation woUd went the suggested course o

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f action, but many would not.CtnciareMost individuals should receive the intenzention. Adherence toths recommendation according to the guiddire couki

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 with lher váưes anti preteiences.Rccognje that different choices will be appropriate for indvidua' patients and that you mist hep each patient arr.ve

at a managerrent doceion consistent with he or her values and preferences. Decision aids may be useful in helpng individuals to make decisions ccnstsi ciw376

eni with liver váues and ixeteiences.PolicyThe reccavncrdaticn can be adopted as policy in most situations.Polcymatang wll requre siiistantial debate

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and nvofvemcnt of various stakeholdersSouiMl C.ÍHÍÍỊ1 trf RwrixnniMoMotk AiMcuirMil. Ck«wix»iH« Í Ni WV>

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 n, comparators, outcomes) questions and associated recommendations, developed based on the evidence that was appraised using GRADE (Grading OÍ Recomme

ndations Assessment. Development, and Evaluation) methodology [1,2], are summarized below. A carefully selected panel of experts, screened for conflic ciw376

ts of interest, including specialists in pulmonary medicine, infectious diseases, pharmacoki-netics. pediatrics, primary care, public health, and syst

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ematic review methodology were assembled and used GRADE methods to assess the certainty in die evidence (also known as the quality of evidence) and st

Clinical Infectious DiseasesIDSA GUIDELINE'ẲlDSẤIiiiiiik’.i muInfxhmi' Diwaqv* Skii ìs QÍhv IftHbeat mwoubonOfficial American Thoracic Society/Centers

ciw376 mend:! lions. Additional detailed discussion of the management of pul monary and extrapulmonary tuberculosis is available in the full text version of

this guideline.OBJECTIVES OF ANTITUBERCULOSIS THERAPYTreatment of tuberculosis is focused on both curing the individual patient and minimizing the tra ciw376

nsmission of Mycobacterium tubercuIrMis Io other persons, thus, successful treatment of til berculosis has benefits both tor the individual patient an

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d the community in which the patient resides.The objectives of tuberculosis therapy arc (1) to rapidly reduce the number of actively growing bacilli i

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