Pre-treatment Evaluation [PTE] in Longer Oral M/XDR-TB Regimen

Pre-treatment evaluation for patients on a longer oral Multi/ Extensively Drug-resistant TB (M/XDR-TB) regimen requires both clinical evaluation and laboratory-based evaluation as given below.

Clinical Evaluation

• Physical examination​
• Height​
• Weight​
• Psychiatric evaluation if required​
• Ophthalmologist opinion (for Linezolid)​
• Surgical evaluation for consideration after culture conversion is achieved​

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Laboratory-based Evaluation​

• Random Blood Sugar (RBS)​
• HIV-testing following counselling​
• Complete blood count (Hb, TLC, DLC, platelet count)​
• Liver function tests (including serum proteins)​
• Thyroid Stimulating Hormone (TSH)​ levels
• BUN and Sr Creatinine- If Amikacin needs to be added​
• Urine examination- routine and microscopic​
• Serum electrolytes (Na, K, Mg, Ca)​
• Urine pregnancy test (in women of reproductive age)​
• Chest X-ray​
• Electrocardiogram (ECG)​

Resources​

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021. 
• WHO Consolidated Guidelines on Tuberculosis: Module 4 – Treatment: Drug-resistant TB Treatment, 2020.

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