世界卫生组织结核病综合业务手册：单元4：治疗和护理

WHOoperationalhandbook ontuberculosisModule 4: treatment and care WHO operational handbook on tuberculosis. Module 4: treatment and careISBN 978-92-4-010814-1 (electronic version)ISBN 978-92-4-010815-8 (print version)© World Health Organization 2025Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence(CC BY-NC-SA 3.0 IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo).Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work isappropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization,products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the sameor equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with thesuggested citation:“This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content oraccuracy of this translation. The original English edition shall be the binding and authentic edition”.Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the WorldIntellectual Property Organization (http://www.wipo.int/amc/en/mediation/rules/).Suggested citation. WHO operational handbook on tuberculosis. Module 4: treatment and care. Geneva: World Health Organization;2025. Licence:CC BY-NC-SA 3.0 IGO.Cataloguing-in-Publication (CIP) data.CIP data are available athttps://iris.who.int/.Sales, rights and licensing.To purchase WHO publications, seehttps://www.who.int/publications/book-orders. To submit requests forcommercial use and queries on rights and licensing, seehttps://www.who.int/copyright.Third-party materials.If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, itis your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. Therisk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user.General disclaimers.The designations employed and the presentation of the material in this publication do not imply the expression of any opinionwhatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitationof its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHOin preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products aredistinguished by initial capital letters.All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the publishedmaterial is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use ofthe material lies with the reader. In no event shall WHO be liable for damages arising from its use.Design by Inis Communication ContentsAcknowledgementsAbbreviations and acronymsDefinitionsExecutive summaryChapter 1. Drug-susceptible TB treatment1. Introduction2. Key considerations in DS-TB treatment3. Treatment of DS-TB using the 6-month regimen4. Treatment of DS-TB using the 4-month 2HPMZ/2HPM regimen5. Treatment of DS-TB using the 4-month 2HRZ(E)/2HR regimen6. Treatment of DS-TB in people living with HIV7. Treatment of extrapulmonary TB8. Treatment of DS-TB in special situations9. Monitoring treatment response10. Outcome definitionsReferences (Chapter 1)Chapter 2. Drug-resistant TB treatment1. Introduction2. WHO recommendations on DR-TB treatment3. Key considerations in DR-TB treatment4. Treatment of DR-TB using 6-month regimens5. Treatment of drug-resistant TB using 9-month regimens6. Treatment of drug-resistant TB using longer regimens7. Regimen for rifampicin-susceptible and isoniazid-resistant TB8. Adjuncts to DR-TB treatment and comorbidities9. Programmatic implementation of DR-TB regimensReferences (Chapter 2) 1117232931354147515961636775101125143149157169 35 Chapter 3. Tuberculosis care and support1811. Introduction1832. People-centred approach1853. Care and support interventions to enable TB treatment adherence1894. Health education and counselling for people affected with TB2015. Models of care for TB services2216. Palliative care233References (Chapter 3)243Annex 1. Tuberculosis medicine information sheets251Annex 2. Monitoring and management of adverse events in treatment ofdrug-resistant tuberculosis307Annex 3. Active TB drug-safety monitoring an