Infectious Disease Epidemiology Program

Tuberculosis - Directly Observed Therpy

Maine Tuberculosis Program Policy
Re: Directly Observed Therapy (DOT)
The Maine TB Control Program and Division of Family Public Health Nursing Services adopted DOT as the standard of care for all persons diagnosed with active TB.

As defined by The Centers for Disease Control and Prevention (CDC) DOT is when a health care worker or other designated individual directly observes the patient swallow the prescribed drugs. Household members should not hold responsibility for DOT.

The Centers for Disease Control and the American Thoracic Society recommend that DOT be considered for all patients as one method of ensuring adherence to a medication regime. Patients who receive DOT can be placed on a twice- or thrice-weekly treatment schedule, generally after two weeks of daily treatment.

In Maine, DOT is typically used with all cases of active, infectious Tuberculosis. DOT may be used for cases of extrapulmonary
TB as determined by the provider and is rarely used for cases of LTBI. DOT may include the use of incentives and enablers to
encourage adherence.

- ATS, Treatment of TB and TB Infection in Adults and Children, American Journal of Respiratory Critical Care Medicine, Vol. 149, Pgs 1359-1374 CDC, Improving Patient Adherence to Tuberculosis Treatment, 1994

- Centers for Disease Control and Prevention – Self-Study Modules on Tuberculosis, Module 9