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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 TuberculosisParam 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." Cynciw376
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 ftcrrahrn. íỉcnera. Swrtmrlms: 'Tufmriints CmtTtt Sertm. San fanctKO Orp.-rt-.crt cf hiNk tterltr. Catfnrri.T ’Ormnn cf kbemitais Flmnaina. Natoml Crntrr hr H ciw376 V/AIPS. Viral tfapatitK STD. srel TO Fhrcntnn. Certfan:far DÍ5TX5T Cmtml trw FYmrntnn. Atimtn. (kxnjn; ’H.-rwni Medial Srh:nl. Bartnt, Mnsuhu*lti “MiGciw376
II Unrmaly. Mmtrsul. Ureliw. Ca sria ' 'two Cdfetautiig Cenbe kr TB art Ung OisttTie®. fwdtoMie s. Mbjiwi Caw «nd Peireidi ketitule. Italsto. IiWy. "lClinical 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 Unxfartity. 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 susceciw376
ptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. RepresentatiClinical 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 health 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,ciw376
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 tubciw376
erculosis treatment and liming of initiation of antiretroviral therapy), as well as treatment of extrap ulmonary disease (central nervous system, periClinical 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; antituhciw376
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;ciw376
Hur-prtsl, Piitrorury aid ũ:t>cal Cme Medóne; 1001 IbliETO fue. SCI. San ItMKirco. Cft 91110 IpníhOíbxĩíMulClinical Infection Diseases* 2016ii7)--e147Clinical 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 Infectious 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 recommciw376
endations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecularDoClinical 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 ociw376
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 debateciw376
and nvofvemcnt of various stakeholdersSouiMl C.ÍHÍÍỊ1 trf RwrixnniMoMotk AiMcuirMil. Ck«wix»iH« Í Nciw376
ematic review methodology were assembled and used GRADE methods to assess the certainty in die evidence (also known as the quality of evidence) and stClinical 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 anciw376
d the community in which the patient resides.The objectives of tuberculosis therapy arc (1) to rapidly reduce the number of actively growing bacilli iGọi ngay
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