1/9/22, 17:55 Rx drug-resistant latent TB - UpToDate

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Suggested regimens for treatment of drug-resistant latent tuberculosis

Pattern of drug resistance Suggested regimen Duration of treatment*

INH, RIF Fluoroquinolone (levofloxacin or 6 to 12 months

moxifloxacin) with or without EMB

INH, RIF, EMB Fluoroquinolone (levofloxacin or 6 to 12 months

moxifloxacin) with or without ETA

INH, RIF, PZA Fluoroquinolone (levofloxacin or 6 to 12 months

moxifloxacin) with or without EMB

INH, RIF, PZA, EMB +/– injectable Fluoroquinolone (levofloxacin or 6 to 12 months

moxifloxacin) with or without ETA

INH, RIF, PZA, EMB, injectable, ETA Fluoroquinolone (levofloxacin or 6 to 12 months

moxifloxacin) with or without CS

INH, RIF, PZA, EMB, fluoroquinolone See note¶ 6 to 12 months

(levofloxacin or moxifloxacin)

The term "drug-resistant tuberculosis" refers to tuberculosis caused by an isolate of Mycobacterium tuberculosis
that is resistant to one of the first-line anti-tuberculosis drugs: isoniazid, rifampin, pyrazinamide, ethambutol, or
streptomycin.

INH: isoniazid; RIF: rifampin; EMB: ethambutol; ETA: ethionamide; PZA: pyrazinamide; CS: cycloserine; PAS: para-
aminosalicyclic acid.

* Longer duration (12 months) of therapy is warranted for patients with immunosuppression, children <5 years,
and individuals with other substantial risk for progression to active TB disease; shorter duration (6 months) is
appropriate for other individuals.

¶ When the resistance pattern limits options for treatment of latent tuberculosis to toxic combinations, clinical
monitoring (symptom review every three to six months for two years with chest radiographs and/or sputum
collection as clinically indicated) in the absence of treatment is reasonable. Prompt pursuit of treatment is
warranted for patients with immunosuppression, children <5 years, and individuals with other substantial risk
for progression to active TB disease; in such cases, possible regimens include two of the following agents: CS,
PAS, and ETA.

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