Rifampicin-Resistant Tuberculosis (RR TB), in Adults

General Measures

Medicine Treatment

Referral

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A15.0-3/A15.7-8/A16.0-2/A16.7-8 + (U50.00-01+U50.20-21) + (B20.0)

Never treat for drug resistant TB without laboratory confirmation, either by molecular or phenotypic (culture and sensitivity) results

GENERAL MEASURES

• Counsel and educate patients about the disease and its treatment, including treatment duration
• Screen all close contacts for signs and symptoms of drug-resistant TB and by sputum sampling to detect early disease
• Infection control and cough etiquette is important to limit spread

MEDICINE TREATMENT

Drug resistant TB prophylaxis

• The effectiveness of preventive therapy in adults exposed to drug resistant TB bacteria is not currently known. Consult a specialist for management

RR-TB and Pre-XDR TB treatment

• Consult the most recent national drug resistant TB programme guidelines. Treatment for 6–18 months is required
• Management of drug resistant TB should be conducted in dedicated drug resistant TB clinics and hospitals with appropriate infection control measures

XDR-TB treatment

• Patients with XDR-TB should be discussed with the National Clinical Advisory Committee (NCAC - NCAC@witshealth.co.za) and referred to a TB hospital for an individualised regimen of at least 4 effective medicines, based on susceptibility tests and treatment history
• Infection control to prevent airborne transmission is essential to prevent nosocomial transmission.

REFERRAL

All drug resistant TB patients to medical officer at primary care level for initiation of therapy.

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4-Version 1.0_16 September 2024

Chapter 17: Respiratory Conditions_17.4 Pulmonary Tuberculosis (TB)_17.4.4 Drug-Resistant Tuberculosis (MDR TB)_17.4.4.2 Rifampicin-Resistant Tuberculosis (RR TB), in Adults