11.6 Patient monitoring

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    Clinical, bacteriological and radiological monitoring is the same as for patients on DS-TB treatment (Chapter 9).  

     

    • If, after the patient has started the standard Hr-TB regimen:
      • fluoroquinolone resistance is detected: perform a new RMT to rule out the emergence of resistance to rifampicin,
      • pyrazinamide resistance is detected: perform a new RMT to rule out the emergence of resistance to rifampicin or fluoroquinolones.
    • Biological monitoring is reinforced and includes the following tests:
      • Patients on pyrazinamide: liver function tests at baseline, then once a month (risk of hepatotoxicity with prolonged use of pyrazinamide).
      • Patients on ethambutol: Ishihara test (Appendix 16) and visual acuity test at baseline, then once a month (risk of visual toxicity with prolonged use of ethambutol).
      • Patients on linezolid:
        • Full blood count at baseline, every 2 weeks for the first 2 months, then once a month.
        • Peripheral neuropathy screening (BPNS, Appendix 16) at baseline, then once a month.
        • Ishihara test (Appendix 16) and visual acuity test at baseline, then once a month.