Peritoneal tuberculosis
ICD-10 A18.3 · ICD-11 1B12.7.2

Treatment of Peritoneal Tuberculosis in Multidrug-Resistant Tuberculosis

Peritoneal tuberculosis in the setting of multidrug-resistant tuberculosis (MDR-TB) is a distinct clinical scenario with its own dedicated treatment protocol. Standard first-line regimens do not apply; a resistance-specific approach is required.

Clinical Scenario — Multidrug-Resistant Tuberculosis

MDR-TB has been documented in 2.4–13.2% of M. tuberculosis strains isolated from newly diagnosed pulmonary TB patients, and in 17.4–25.5% of previously treated patients. When peritoneal tuberculosis is diagnosed in this context, resistance-appropriate regimen selection is essential.

Treatment Approach

Management is guided by the WHO shorter MDR-TB regimen, which structures treatment across an initial phase and a subsequent intensive continuation phase involving multiple agents. The specific drugs, phase durations, and sequencing criteria are detailed in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

  1. Multidrug resistance (MDR) has been observed in 2.4–13.2% of strains of MTB isolated from newly diagnosed pulmonary TB patients and in 17.4–25.5% of previously treated patients.
  2. Kanamycin (an injectable agent), moxifloxacin, prothionamide, clofazimine, isoniazid, pyrazinamide and ethambutol, given together in an initial phase of 4 months (with the option of extending to 6 months if the patient is still positive on a sputum smear at the end of month 4).
  3. Followed by an intensive phase of 5 months of treatment with four of the medicines (moxifloxacin, clofazimine, pyrazinamide, and ethambutol).
  4. Medicines are taken once per day, all days of the week.
  5. If the intensive phase is prolonged, the injectable agent is only given three times a week after the fourth month.
View source ↗