Monitoring

Baseline hepatic panel

Creatinine and CBC are recommended for all adults initiating TB treatment.

Monthly hepatic panel is recommended for patients with baseline abnormalities, history of liver disease or viral hepatitis, chronic alcohol consumption, HIV, IVDU, pregnancy or immediate post-partum state, or those taking other potentially hepatotoxic medications.

Therapy should be discontinued immediately if AST and ALT are >3 times the upper limit of normal in the presence of jaundice or hepatitis symptoms OR >5 times the upper limit of normal in the absence of symptoms.

All patients should be followed by a provider experienced in management of tuberculosis.

Any changes in TB drug regimen or particularly toxicity resulting in cessation of therapy MUST be communicated to LA County TB control and UCLA Infection Prevention.