In the treatment monitoring of patients under SSOR and SLOR, when is total bilirubin tested?

Total bilirubin is assessed when the ALT (alanine aminotransferase) and AST (aspartate aminotransferase) levels are higher than the upper limit of normal. This testing is important because elevated levels of these liver enzymes can indicate liver stress or damage, which may be exacerbated by certain tuberculosis treatments. Monitoring total bilirubin in this context helps to ensure that any potential liver-related adverse effects are identified and managed promptly.

In routine treatment monitoring, total bilirubin may not need to be tested monthly throughout the treatment or specifically during the intensive phase unless there are indicators of hepatic toxicity, such as elevated ALT and AST levels. While certain regimens may include medications like amikacin, total bilirubin testing is primarily guided by the liver enzyme levels rather than being automatically linked to the presence of specific medications, making those choices less relevant in this context.

Thus, the rationale for testing total bilirubin is closely tied to monitoring liver function and safety in patients who may be experiencing the effects of their treatment, making it critical to test it in response to high liver enzyme levels.