Revised tuberculosis guideline

14 March, 2019

Dear All

Recently I noticed from our national tuberculosis control programme, Bangladesh that Cat-II regimen withdrawn and introduction of 6 month of 4FDC with Livofloxacin in rif sensitive cases. In Rif resistant DST (not readily available) should be done and treatment accordingly. In extrapulmonary tb Levo based 4FDC even in tb meningitis though CNS concentration of Levo is very poor. This may be WHO decision. Many patients diagnosed emperically practically without any direct evidence but improved with tb drug. Some times patients are so complicated with so many co morbid illness that separate drugs are needed that is now not available as it is not selling in private sector. I think this is premature decisions however more clear explanation and grade based guideline should be developed, and more option of regimen should be included. I am expecting your opinion and any resources supporting this new regimen.

HIFA profile: Ariful Basher is a Medical Officer with the Kala Azar project, SK Hospital, Mymensingh, Bangladesh. Professional interests: Tropical medicine, Infectious diseases and Clinical toxicology. arifulbasher AT yahoo.com