Rapid diagnostic tests can be used for patients with tuberculosis, HIV, AIDS positive AFB smear sputum. Respiratory isolation should be initiated if the patient is coughing. Patients should be started on a 4-drug regimen consisting of isoniazid, rifampin, pyrazinamide, and either ethambutol or streptomycin. In areas with multi-drug resistant strains, consideration should be given to using all five drugs and perhaps adding a quinolone. After susceptibility results are known, the treatment regimen can be modified.
Treatment is continued for at least three months after the last negative sputum culture.
If DOT is not available, combination tablets should be used. Response to therapy is signified by resolution of fever, cough, sputum production, and hemoptysis. Most patients are culture-negative by 3 months. If sputum smears remain persistently positive, non-compliance should be suspected and supervised daily therapy considered. If non-compliance is unlikely, then drug resistance should be considered.