Male genital tuberculosis
ICD-10 A18.1 ICD-11 1B12.5.1

Treatment of Newly Diagnosed Male Genital TB Without Rifampicin or Isoniazid Resistance

Clinical scenario

This protocol applies to patients with newly diagnosed genitourinary tuberculosis (GUTB) — including male genital TB — where susceptibility testing has confirmed no resistance to rifampicin and isoniazid. This is a standard first-line setting, distinct from multidrug-resistant TB (MDR-TB) which requires a separate individualised approach.

Treatment approach

Management follows a structured daily six-month regimen divided into two phases: an intensive initial phase combining multiple first-line antitubercular agents, followed by a shorter continuation phase. The full sequence of agents, phase durations, and dosing parameters are defined in the complete protocol.

Complete regimen details are available in the full protocol below.
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References

The WHO recommends a six-month daily regimen for treatment of newly diagnosed extrapulmonary TB, including an intensive phase of two months with isoniazid, rifampicin, pyrazinamide and ethambutol, followed by a continuation phase of four months with isoniazid and rifampicin.

For the treatment of multidrug-resistant (MDR) TB (i.e. resistance to rifampicin and isoniazid), an individualised treatment regimen should be applied with at least five effective tuberculosis medicines during the intensive phase, including pyrazinamide and four core second-line tuberculosis medicines.

Use a daily six-month regimen for treatment of newly diagnosed GUTB. This should include an intensive phase of two months with isoniazid, rifampicin, pyrazinamide and ethambutol, followed by a continuation phase of four months with isoniazid and rifampicin.

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