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Treatment of Active Tuberculosis Disease

General information

San Mateo County follows treatment recommendations for active tuberculosis disease set forth by the California Tuberculosis Controller’s Association (CTCA) adapted from the Centers for Disease Control (CDC).  The recommendations by the CTCA differ slightly from the CDC’s guidelines.  An overview of the differences can be found on the CTCA Website

We have also highlighted below important matters for managing a patient with active TB disease in San Mateo County.

Treatment Monitoring

For patients with drug susceptible tuberculosis, San Mateo County follows a specific schedule of monitoring. This allows for appropriate assessment of clinical improvement.  While all components of monitoring are essential, of particular importance to patient treatment is documented culture conversion after 8 weeks of treatment.

Directly Observed Therapy (DOT)

San Mateo County uses DOT as a tool to support patients through a lengthy course of treatment, improve tuberculosis treatment adherence, and minimize adverse outcomes.  All patients with pulmonary TB or drug resistant TB, as well as patients on intermittent regimens should be on DOT.  DOT is also strongly recommended for others at high risk for serious outcomes, or poor adherence.  To learn more, read the handout entitled Information for Physicians: Directly Observed Therapy.

HIV Testing

Since HIV co-infection is a significant risk factor for progression to active tuberculosis disease, and also alters medical management of tuberculosis, San Mateo County follow the California Department of Public Health (CDPH) and Centers for Disease Control (CDC) recommendation that all patients with suspected or confirmed tuberculosis be tested for HIV.  Additional information about who should be tested for HIV, and why can be found in the San Mateo County HIV Testing Memo [PDF].

Do you have questions?

We are available for consultation at 650-573-2346.

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