Extrapulmonary tuberculosis

The basic principles that underlie the treatment of pulmonary tuberculosis also apply to
extrapulmonary forms of the disease. Although relatively few studies have examined
treatment of extrapulmonary tuberculosis, increasing evidence suggests that 6- to 9-month
regimens that include INH and RIF are effective. Thus, a 6-month course of therapy is
recommended for treating tuberculosis involving any site with the exception of the meninges,
for which a 9- 12-month regimen is recommended. Prolongation of therapy also should be
considered for patients with tuberculosis in any site that is slow to respond. The addition of
corticosteroids is recommended for patients with tuberculous pericarditis and tuberculous
meningitis.
American Thoracis Society 2004.
https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm
6. Paduan OAT KDT Lini Pertama dan Peruntukannya.
a. Kategori-1 : 2(HRZE) / 4(HR)3
Paduan OAT ini diberikan untuk pasien baru:
Pasien TB paru terkonfirmasi bakteriologis.
Pasien TB paru terdiagnosis klinis
Pasien TB ekstra paru
DEPKES 2014
6.8 Treatment of Extra-pulmonary TB
Patients with EPTB are given the standardised treatment regimen for 6 months as
above except for those with TB of the meninges, bone, joint, pericardium,
disseminated or spinal disease with neurological complications who should have a
prolonged continuation phase of six months, i.e. 2HRZE/6HR. Streptomycin should be
used instead of ethambutol in case of TB meningitis.
WHO 2010
TREATMENT In general, the approach to antimicrobial therapy for treatment of miliary
tuberculosis (TB) is the same as for pulmonary TB [98]. This approach is based upon
retrospective review of a relatively small number of patients with extrapulmonary TB, since
extrapulmonary TB is much less common than pulmonary TB. While the data suggest that
this approach is successful, individualization of regimens may be warranted.
Jurnal Uptodate 2015 http://www.uptodate.com.sci-hub.cc/contents/clinical-manifestationsdiagnosis-and-treatment-of-extrapulmonary-and-miliary-tuberculosis#H21

TREATMENT Selection of treatment regimens for tuberculous peritonitis is based upon

the same principles as the selection for pulmonary tuberculosis. (See "Treatment of
pulmonary tuberculosis in HIV-uninfected adults" and "Clinical manifestations, diagnosis,
and treatment of extrapulmonary and miliary tuberculosis".)

The addition of corticosteroids for the first two to three months of treatment may reduce the
incidence of late complications arising from adhesive disease, such as small bowel
obstruction [12,50,58]. However, most clinicians avoid using adjunctive steroid therapy since
its efficacy has not been well established, and because of the risk of tuberculous
dissemination in the setting of multi-drug resistance.
Jurnal uptodate 2014 http://www.uptodate.com.sci-hub.cc/contents/tuberculous-peritonitis?
source=see_link#H11