Directly observed therapy (DOT)

Directly Observed Therapy (DOT) is often short course and is an approach to patient management wherein every medication is taken under observation by a health care worker.

It is a very costly approach, as DOT may be needed for 6 to 9 months. The need for DOT is caused by the frequent lack of drug compliance on the part of some patients with active TB and has been developed to overcome this problem.

DOT has had a dramatic effect in reducing the number of new cases per year, has been associated with a decrease in development of multi-drug resistant TB organisms, and has brought about proper and complete therapy in many patients with active TB who would never have taken their medications properly.

Priority situations for the use of DOT:

  1. Patients with the following conditions/circumstances:
    • Pulmonary TB with positive sputum smears
      • HIV infection
      • Current or prior substance abuse
      • Treatment failure Drug resistance
      • Relapse
      • Previous treatment of either active TB or latent TB infection (LTBI)
      • Current or prior substance abuse
      • Psychiatric illnesses
      • Memory impairment
      • Previous non-adherence to therapy
  2. Children and adolescents

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