American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended length of therapy continuation for certain patients with active tuberculosis?

1. 4 months

2. 6 months

3. 7 months

4. 12 months

The correct answer is: 7 months

The recommended length of therapy continuation for certain patients with active tuberculosis is 7 months, which is based on treatment guidelines for specific scenarios such as patients with drug-susceptible pulmonary tuberculosis. In most cases, the standard duration of therapy for drug-susceptible tuberculosis is typically 6 months, consisting of an intensive phase followed by a continuation phase. However, for patients who present with more complicated cases, such as those with bacteriologically confirmed pulmonary tuberculosis who have had a delayed sputum culture conversion or those who remain smear-positive at the end of the intensive phase, extending the treatment to 7 months helps ensure all bacteria are eradicated, reducing the risk of recurrence and transmission. In addition, the length of therapy may adjust for certain individual factors, including the presence of extrapulmonary tuberculosis, previous treatment history, or complications with adherence to therapy. While durations of therapy longer than 7 months can occur in special populations, such as those with resistant tuberculosis or poor response to treatment, they are typically not necessary for overall straightforward cases. This understanding underlines the importance of personalized treatment regimens based on patient factors and illness severity when treating active tuberculosis.