Tuberculosis Treatment And Referral Information

Latent Tuberculosis Infection Treatment

Treatment of latent Tuberculosis Infection (LTBI) greatly reduces the risk that TB infection will progress to disease. Certain groups are at very high risk of developing TB disease once infected. Every effort should be made to begin appropriate treatment and to ensure those persons complete the entire course of treatment for LTBI.

Treatment of latent TB infection (LTBI) should be initiated after the possibility of TB disease has been excluded. The three treatment regimens use isoniazid (INH) or rifampin (RIF). INH for nine months is the preferred regimen. Treatment must be modified if the patient is a contact of an individual with INH or multidrug-resistant TB. A new regimen with twelve weekly doses was approved in 2011. This regimen requires directly observed therapy.

Referring Patients to Special Services

Persons suspected of having TB disease should be referred to the RISE Clinic.

RISE Clinic

The RISE Clinic is the state-funded TB clinic in Rhode Island. Patients with suspect or confirmed TB disease or LTBI can be referred to the RISE Clinic for specialty care. The RISE Clinic is a referral only clinic; walk-ins and patient self-referrals are not accepted.

To refer a patient to the RISE Clinic, the provider must complete the referral form, confirm the appointment time with the patient, and fax the form to the RISE Clinic. Contact the RISE Clinic to obtain available appointments and facilitate appropriate triage.

The RISE Clinic will triage the patient. If you suspect that the patient has active TB and/or an abnormal chest x-ray, you must speak with the RISE Clinic physician to discuss the case. The RISE staff will then collect any pertinent information so that the patient can be seen as soon as possible.

Directly Observed Therapy (DOT) Program

Directly observed therapy (DOT) is the standard of care for all TB disease cases in the state. Upon receiving a report of a new TB disease case and a prescription from the TB clinician for the case, the TB Program will match the case with a DOT outreach worker based on culture and language needs. Every treatment dose will be administered to the patient under direct observation by the DOT outreach worker.