Drug-resistant tuberculosis treatment

5.5 Monitoring and evaluation
Culture and microscopy results for tests performed in patients on MDR-TB treatment should be 
captured in the second-line TB treatment register as well as the respective laboratory registers (41). 
Sometimes these registers may exist as part of an electronic laboratory or patient information system, 
which facilitates greatly the access of data in real time by multiple users and can also help limit errors. 
It is important for the programme manager to assess the records in the second-line TB treatment 
register for completeness of testing using both culture and sputum smear microscopy, any discordance 
between the two modalities, and whether decisions on regimen changes or assignment of outcome 
are coherent (e.g. does a case have sufficient negative culture test results available to be classified 
as Cured?). Performance indicators help improve the quality of care, such as contamination rates, 
turnaround times and proportion of culture tests done without results being recorded in the patient 
information system. In the case of repeated positive cultures, repeat testing for drug susceptibility or 
resistance is
important.

---

Recommendations 
58
Section 6. Starting antiretroviral therapy in patients 
on second-line antituberculosis regimens
6.1 Recommendation
No.
Recommendation
6.1
Antiretroviral therapy is recommended for all patients with HIV and drug-resistant 
tuberculosis requiring second-line antituberculosis drugs, irrespective of CD4 
cell count, as early as possible (within the first 8 weeks) following initiation of 
antituberculosis treatment. 
(Strong recommendation, very low quality
 
evidence)
6.2 Justification and evidence
The recommendation in this section addresses one PICO
question: