WHO operational handbook on tuberculosis: module 4: treatment: drug-susceptible tuberculosis treatment

This operational handbook provides practical guidance for implementing WHO recommendations on the treatment of drug-susceptible tuberculosis (DS-TB). Developed within the framework of the End TB Strategy, the publication complements the WHO consolidated guidelines on tuberculosis by translating evidence-based policy recommendations into operational and clinical guidance for national tuberculosis programmes, policy-makers and health practitioners. It addresses diagnostic considerations, including rapid molecular testing and drug susceptibility testing, and outlines patient-centred approaches to treatment support, monitoring and follow-up.

The handbook describes the recommended 6-month rifampicin-based regimen for DS-TB and two newer 4-month regimens for specific patient groups, including adults, adolescents and children with non-severe disease. It details eligibility criteria, regimen composition, dosing, monitoring requirements and implementation considerations for different populations, including people living with HIV, pregnant women, children and patients with comorbidities such as diabetes, chronic renal failure and chronic liver disease. Additional sections cover treatment of extrapulmonary tuberculosis, management in special situations, use of adjunctive corticosteroids, treatment outcome definitions and weight-based dosing of first-line anti-tuberculosis medicines.