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    Disclaimer

    Buku ini didanai oleh United States Agency for International Development dibawah

    USAID Tuberculosis CARE I, Cooperative Agreement No. AID-OAA-A-10-00020

    Buku ini menjadi mungkin berkat dukungan yang baik dari rakyat Amerika melaluiUnited States Agency for International Development (USAID). Isi menjadi tanggung

    jawab TB CARE I dan tidak mencerminkan visi USAID atau Pemerintah AmerikaSerikat.

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    vPedoman Nasional Pelayanan Kedokteran

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    vi TATA LAKSANA TUBERKULOSIS

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    viiPedoman Nasional Pelayanan Kedokteran

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    ixPedoman Nasional Pelayanan Kedokteran

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    x TATA LAKSANA TUBERKULOSIS

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    1Pedoman Nasional Pelayanan Kedokteran

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    2 TATA LAKSANA TUBERKULOSIS

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    3Pedoman Nasional Pelayanan Kedokteran

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    5Pedoman Nasional Pelayanan Kedokteran

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    6 TATA LAKSANA TUBERKULOSIS

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    8 TATA LAKSANA TUBERKULOSIS

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    9Pedoman Nasional Pelayanan Kedokteran

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    10 TATA LAKSANA TUBERKULOSIS

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    11Pedoman Nasional Pelayanan Kedokteran

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    12 TATA LAKSANA TUBERKULOSIS

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    13Pedoman Nasional Pelayanan Kedokteran

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    14 TATA LAKSANA TUBERKULOSIS

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    15Pedoman Nasional Pelayanan Kedokteran

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    16 TATA LAKSANA TUBERKULOSIS

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    17Pedoman Nasional Pelayanan Kedokteran

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    18 TATA LAKSANA TUBERKULOSIS

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    19Pedoman Nasional Pelayanan Kedokteran

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    20 TATA LAKSANA TUBERKULOSIS

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    21Pedoman Nasional Pelayanan Kedokteran

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    22 TATA LAKSANA TUBERKULOSIS

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    5%+4(#(- .%3$*-$. -(&'%" 6%+'.,5 '"' -(#( &((5 *,3(' -%"/$6(5("`

    I%*,( -(&'%" #%"/(" +'E(7(5 H?

  • 5/21/2018 PNPK TB

    33/120

    23Pedoman Nasional Pelayanan Kedokteran

    E)&=B) +=,L),2>=,%* 56> ')2>2&),2> =(%&

    !Q

    -&5$12+0"0:(+( :%-(5 #'6("#'"/.(" *%#'( -(#(5 &(2(8 M%5$#% :('+ 3%6'4 &%"&'5';

    *%"#%5%.&' *'.$6(.5%+',* #(" *%"'"/.(5.(" -%"%*,(" .(&,& &%6%&(+ UAB

    #'6("#'"/.(" *%#'( -(#(5 #' &(*-'"/ 3%6'4 :%-(5 *%*-%+$3%4 4(&'3 &%.'5(+ UA 4(+'

    #'6("#'"/.(" OC01O 4(+' #%"/(" *%#'( -(#(58D

    E)&=B) ')2>2&),2> =(%& M56> B>%-,=2&>+ 1=*)+5*%'

  • 5/21/2018 PNPK TB

    34/120

    24 TATA LAKSANA TUBERKULOSIS

    O%1(%' H"/"?3/$+'5*% #'(/"$&'& -(+, -(#( #%E(&(

    Suspek TB

    Sputum mikroskopia (BTA)

    BTA (+) BTA (-)

    Kasus definitif TB BTA (+) Lihat klinis dan foto toraks

    Tidak sesuai TB Sesuai TB

    Antibiotik 2 minggu Kasus TB BTA (-)

    Perbaikan

    Bukan TB

    Tidak perbaikan, klinis sesuai TB

    Obati sesuai kasus TB BTA (-)serta melakukan pemeriksaan

    biakan sputum M.tb

    Foto toraks

  • 5/21/2018 PNPK TB

    35/120

    25Pedoman Nasional Pelayanan Kedokteran

    7" 0),-=(%&%, &5()'+5*=2>2 ;%'5

    +1#6 ?$/#-9 41@/%"A/-"+%*%+%.$*%"#(&'.(" $6(5 .$*6'"(&' #$&'& 5%5(- FPG>Q

    VC0D1 ./ >>Q DD0@A ./ >> #(" 3%6'4 #(+' @A ./ >>8e

    .%()* H"/" G$&'& +%.$*%"#(&' H?< 3'"' -%+5(*( ,"5,. #%E(&(

    H?>J

    M(.&'*,*

    F*/J

    G$&'&

    F*/X./>>J

    M(.&'*,*

    F*/J

    !&$"'(a'# D F10bJ VAA UA FC0UOJ eAA

    S';(*-'&'" UA FC0UOJ bAA UA FC0UOJ bAA

    9'+(a'"(*'# OD FOA0VAJ 0 VD FVA01AJ 0

    [5(*6,5$3 UD FUD0OAJ 0 VA FOD0VDJ 0

    I5+%-5$*'&'"q UD FUO0UCJ UD FUO0UCJ UAAA

    q9(&'%" 6%+,&'( #' (5(& bA 5(4," 5'#(. #(-(5 *%"5$3%+("&' 3%6'4 #(+' DAA0@AA */ -%+ 4(+'Q 6%6%+(-( -%#$*(" *%+%.$*%"#(&'.("

    #$&'& UA */X./ >> -(#( -(&'%" .%3$*-$. ,&'( '"'8 9(&'%" #%"/(" 6%+(5 6(#(" #' 6(E(4 DA ./ 5'#(. #(-(5 *%"5$3%+("&' #$&'&

    3%6'4 #(+' DAA0@DA */ -%+ 4(+'8

    G'.,5'- #(+' FOJ

  • 5/21/2018 PNPK TB

    36/120

    26 TATA LAKSANA TUBERKULOSIS

    I%*,( -(&'%" F5%+*(&,. *%+%.( 7("/ 5%+'";%.&' R!WJ 7("/ 6%3,* -%+"(4 #'$6(5' 4(+,& #'6%+'

    -(#,(" $6(5 7("/ #'&%-(.(5' &%:(+( '"5%+"(&'$"(3 *%"//,"(.(" $6(5 7("/ 6'$(N('3(6'3'5(&"7(

    5%3(4 #'.%5(4,'8 \(&% '"'&'(3 &%4(+,&"7( 5%+#'+' (5(& '&$"'(a'#Q +';(*-'&'"Q -'+(a'"(*'#Q #("

    %5(*6,5$38 \(&% 3("2,5(" &%4(+,&"7( 5%+#'+' (5(& '&$"'(a'# #(" +';(*-'&'" 7("/ #'6%+'.(" &%3(*(

    1 6,3("8 G$&'& $6(5 ("5' 7("/ #'/,"(.(" 4(+,& &%&,(' #%"/(" +%.$*%"#(&' '"5%+"(&'$"(38

    P$*6'"(&' #$&'& 5%5(- 7("/ 5%+#'+' (5(& .$*6'"(&' O $6(5 F'&$"'(a'#JQ V $6(5 F'&$"'(a'#Q

    +';(*-'&'"Q #(" -'+(a'"(*'#JQ #(" 1 $6(5 F'&$"'(a'#Q +';(*-'&'"Q -'+(a'"(*'#Q #(" %5(*6,5$3J

    &("/(5 #'+%.$*%"#(&'.("8

    )*+'$+, < /'*%,'+*#0'+& )*+'$+,$( 10, 2"3%,4"&0(#( 5+,%

    0%B5%, =(%& 2&%,B%' 5,&5+ ;%2>), B),-%, +%252 (%'5

    9(&'%" #%"/(" .(&,& 6(+, #'(&,*&'.(" -%.( 5%+4(#(- H?< .%:,(3'`O

    ! 5'"//(3 #' #(%+(4 #%"/(" -+%N(3%"& 5'"//' +%&'&5%" '&$"'(a'#

    ?

  • 5/21/2018 PNPK TB

    37/120

    27Pedoman Nasional Pelayanan Kedokteran

    .%()* H"C" 0%B5%, =(%& 2&%,B%' ;%2>), .4 +%252 (%'5 MB),-%, %2512> %&%5

    B>+)&%35> ;)+% @!.N

    \(&% '"5%"&'; \(&% 3("2,5("

    SR_[ O 6,3(" SR 1 6,3("

    G'.,5'- #(+' FOJ

    >%+#(&(+.(" 4(&'3 -%"%3'5'(" *%5(("(3'&'& *(.( ^RH *%+%.$*%"#(&'.(" -(#,(" &5("#(+

    ,"5,. -(+, .(&,& 6(+, (#(3(4 OSR_[X1SR

    P)+=1),B%2> !

    9(#,(" (35%+"(5'; OSR_[X1SVR

    V4(+,& #'&%+5(' -%"/(E(&(" .%5(5 &%:(+( 3("/&,"/ ,"5,. &%5'(-

    #$&'& $6(58P)+=1),B%2> 4

    .#+5/# F#/% -+ 8-+, 7J CDDS:CDET *%":("("/.(" 5(+/%5 ,"5,. &%*,( -(&'%" #%"/("

    +'E(7(5 -%"/$6(5(" H?< 4(+,& #'-%+'.&( ,2' +%&'&5%"&' H?< -(#( (E(3 -%"/$6(5("8

    L2' +%&'&5%"&' $6(5 #'3(.,.(" &%#'.'5"7( ,"5,. '&$"'(a'# #(" +';(*-'&'" #(" 5,2,(""7(

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    T%"'& -%"/$6(5(" H?< ,3("/ 6%+/("5,"/ -(#( .(-(&'5(& 3(6$+(5$+',* #(%+(4

    &%5%*-(58 >'3( 5%+#(-(5 3(6$+(5$+',* 7("/ #(-(5 *%3(.,.(" ,2' +%&'&5%"&' $6(5

    6%+#(&(+.(" ,2' *$3%.,3(+ :%-(5 #(" *%"#(-(5.(" 4(&'3 #(3(* U0O 4(+' *(.( 4(&'3

    '"' #'/,"(.(" ,"5,. *%"%"5,.(" -(#,(" H?< -(&'%"8UV >'3( 3(6$+(5$+',* 4("7(

    #(-(5 *%3(.,.(" ,2' +%&'&5%"&' $6(5 .$"N%"&'$"(3 #%"/(" *%#'( :('+ (5(, -(#(5

    #(" *%"#(-(+.(" 4(&'3 #(3(* 6%6%+(-( *'"//, (5(, 6,3(" *(.( #(%+(4 5%+&%6,5

    &%6('."7( *%"//,"(.(" -(#,(" %*-'+'& &(*6'3 *%","//, 4(&'3 ,2' +%&'&5%"&' $6(58O

    9(&'%" #%"/(" .(&,& &%-%+5' '"' #(-(5 *%"%+'*( .%*6(3' -(#,(" H?< 3'"' -%+5(*(

    FOSR_[IXUSR_[XDSR[J8OQU19%+3, #':(5(5 6(4E( -%"/$6(5(" ,3("/ #%"/(" -(#,("

    H?< 3'"' -%+5(*( '"' 5'#(. #'#,.,"/ $3%4 6,.5' ,2' .3'"'&8 M%5$#% '"' #'#%&('" ,"5,.

    #'/,"(.(" -(#( #(%+(4 #%"/(" -+%N(3%"& +%"#(4 +%&'&5%" $6(5 -+'*%+ #(" 6(/'

  • 5/21/2018 PNPK TB

    38/120

    28 TATA LAKSANA TUBERKULOSIS

    -(&'%" 7("/ &%6%3,*"7( #'$6(5' #%"/(" -(#,(" 7("/ *%"/("#,"/ +';(*-'&'" -(#(

    ;(&% O 6,3(" -%+5(*(8UD

    9%"'3('(" .%*,"/.'"(" +%&'&5%"&' $6(5Q 6%+#(&(+.(" +'E(7(5 -%"/$6(5(" 5%+#(4,3,Q -(2("("

    #%"/(" &,*6%+ 7("/ *,"/.'" +%&'&5%" $6(5Q #(" -+%N(3%"& +%&'&5%"&' $6(5 #(3(* *(&7(+(.(5&%4(+,&"7( #'3(.,.(" -(#( &%*,( -(&'%"8 L2' +%&'&5%"&' $6(5 &%4(+,&"7( #'3(.,.(" -(#( (E(3

    -%"/$6(5(" ,"5,. &%*,( -(&'%" 7("/ &%6%3,*"7( -%+"(4 #'$6(5'8 9(&'%" 7("/ (-,& #(4(. 5%5(-

    -$&'5'; &%5%3(4 -%"/$6(5(" 5'/( 6,3(" &%3%&(' #(" -(&'%" /(/(3 -%"/$6(5("Q -,5,& $6(5Q (5(, .(&,&

    .(*6,4 &%5%3(4 -%"/$6(5(" 4(+,& &%3(3, #'"'3(' 5%+4(#(- +%&'&5%"&' $6(58 L"5,. -(&'%" #%"/("

    .%*,"/.'"(" +%&'&5%"&' $6(5Q 6'(.(" #(" ,2' &%"&'5'N'5(&X+%&'&5%"&' $6(5 &%5'#(."7( 5%+4(#(-

    '&$"'(a'# #(" +';(*-'&'" &%4(+,&"7( #'3(.&("(.(" &%/%+( ,"5,. *%*'"'*(3.(" .%*,"/.'"("

    -%",3(+("8 K(+(0:(+( -%"/$"5+$3(" '";%.&' 7("/ *%*(#(' &%4(+,&"7( #'3(.,.("8

    )*+'$+, .. /'*%,'+*#0'+& )*+'$+,$( 10, 2"3%,4"&0(#( 5+,%

    0)1%,&%5%, ')2;=,2 ;),-=(%&%,

    I%*,( -(&'%" 4(+,& #'-("5(, ,"5,. *%"'3(' +%&-$"& 5%+(-'8 9%*("5(,(" 7("/ +%/,3(+

    5'#(. #''"/'".("8 I%*,( -(&'%"Q 9MH #(" 5%"(/( .%&%4(5(" &%6('."7( #'*'"5( ,"5,.

    *%3(-$+.(" /%2(3( 7("/ *%"%5(- (5(, *,":,3 .%*6(3'Q /%2(3( %;%. &(*-'"/ H?%+(5 6(#(" -(&'%" 4(+,& #'-("5(, &%5'(- 6,3(" #(" #$&'& H?< #'&%&,('.(" #%"/("

    -%+,6(4(" 6%+(5 6(#("8 S%&-$"& -%"/$6(5(" -(+, #'-("5(, #%"/(" (-,&(" #(4(.

    >

  • 5/21/2018 PNPK TB

    39/120

    29Pedoman Nasional Pelayanan Kedokteran

    ?-,&(" #(4(. >

  • 5/21/2018 PNPK TB

    40/120

    30 TATA LAKSANA TUBERKULOSIS

    9(#( #(%+(4 7("/ 5'#(. *%*'3'.' .(-(&'5(& 3(6$+(5$+',* ,"5,. 6'(.(" #(" ,2'

    +%&'&5%"&' $6(5 *(.( -%*("5(,(" 5(*6(4(" #%"/(" (-,&(" #(4(. >

  • 5/21/2018 PNPK TB

    41/120

    31Pedoman Nasional Pelayanan Kedokteran

    ;),-=(%&%, 2)()*51,K%

    9(#( -(&'%" #%"/(" +'E(7(5 -%"/$6(5(" &%6%3,*"7( 6'3( &-%&'*%" 7("/ #'-%+$3%4

    -(#( (.4'+ ;(&% '"5%"&'; F6,3(" .%5'/(J (#(3(4 >

  • 5/21/2018 PNPK TB

    42/120

    32 TATA LAKSANA TUBERKULOSIS

    .%()* H"F"

    I%*6,4

    -%"/$6(5(" #(" (-,&(" #(4(. >

  • 5/21/2018 PNPK TB

    43/120

    33Pedoman Nasional Pelayanan Kedokteran

    TB Paru

    TB Paru Kasus Baru TB Paru Kasus Pengobatan Ulang

    OAT Kategori I OAT Kategori II, bila terdapat hasil biakansputum M.Tb dan uji kepekaan obat maka

    terapi disesuaikan

    O%1(%' H"C8 ?3/$+'5*% -%"/$6(5(" -(+, -(#( #%E(&(8

    Q:)+ @!. K%,- &>B%+ B>>,->,+%,

    I%6(/'(" 6%&(+ -(&'%" #(-(5 *%"7%3%&('.(" -%"/$6(5(" 5("-( .%2(#'(" 5'#(.

    #''"/'".(" 7("/ 6%+*(."( "(*," &%6(/'(" .%:'3 #(-(5 *%"/(3(*'"7(8 P(+%"( '5,

    -%"5'"/ *%*("5(, .3'"'& -(&'%" &%3(*( -%"/$6(5(" &%4'"//( %;%. 5'#(. #''"/'".("

    #(-(5 #'#%5%.&' &%/%+( #(" #'5(5( 3(.&("( #%"/(" 5%-(58 9(&'%" 7("/ &%4(5 #(-(5

    *%":%/(4 %;%. &(*-'"/ '"#,.&' $6(58 =%,+$-(5' -%+';%+ &%-%+5' .%6(& (5(, +(&(

    &%-%+5' 5%+6(.(+ -(#( 5("/(" (5(, .(.' &%+'"/ 5%+2(#' -(#( -%+%*-,(" 4(*'3Q '";%.&'

    R!WQ -%"7(3(4/,"((" (3.$4$3Q *(3",5+'&'Q #'(6%5%&Q -%"7(.'5 4(5' .+$"'.Q /(/(3

    /'"2(38O9(#( -(&'%" &%-%+5' '"' &%6('."7( #'6%+'.(" -%"/$6(5(" -%":%/(4(" #%"/("

    -'+'#$.&'" OD */X 4(+' 6%+&(*( #%"/(" H?

  • 5/21/2018 PNPK TB

    44/120

    34 TATA LAKSANA TUBERKULOSIS

    .%()* H"H" 9%"#%.(5(" 6%+#(&(+.(" /%2(3( ,"5,. *%"/$6(5' %;%. 5'#(. #''"/'".(" H?B%+ B>>,->,+%, MQ.9N G)15,-+>,%,

    =(%& ;),K)(%( 0),-=(%&%,

    !/3+1?$%-"U/% +5/- ,$%3$5/5 6/% 1&V&U

    U$,/6/ 6+U-$1 /9#" 0$@$1/

    S,(* .,3'5 #%"/(" (5(, 5("-( /(5(3 I5%+-5$*'&'"Q'&$"'(a'#Q

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    !Q -&5$12+0"07('5,`U

    M$"$+%&'&5%"` '&$3(5!Q -&5$12+0"0.%6(3 5%+4(#(- &(3(4 &(5, H?< 3'"' -%+5(*(8

    9$3'+%&'&5%"` '&$3(5!Q -&5$12+0"0.%6(3 #,( (5(, 3%6'4 H?< 3'"' -%+5(*( &%3('"

    .$*6'"(&' +';(*-'&'" #(" '&$"'(a'#8

    S%&'&5%" $6(5 /("#( (5(, #'.%"(3 #%"/(" '-"61&@:1$0"0-/%- -&5$12+0"0 FMGS0

    J` '&$3(5 !Q -&5$12+0"0+%&'&5%" *'"'*(3 5%+4(#(- '&$"'(a'# ("# +';(*-'&'"

    7('5, H?< 7("/ -(3'"/ .,(5 #%"/(" (5(, 5("-( #'&%+5(' +%&'&5%" 5%+4(#(- H?'(&("7( -(#,(" -%"/$6(5(" %*-'+'& (.(" #'&%&,('.("

    &%5%3(4 (#( 4(&'3 ,2' +%&'&5%"&' $6(5 '"#'N'#,(38

    9%"/$6(5(" -(#,(" '"#'N'#,(38 9(#,(" -%"/$6(5(" 6%+#(&(+.(" +'E(7(5

    -%"/$6(5(" &%6%3,*"7( #(" 4(&'3 ,2' +%&'&5%"&' -(&'%" 6%+&("/.,5("8

    9(#,(" $6(5 &5("#(+ +%&'&5%" $6(5 /("#( #' !"#$"%&'( (#(3(4 *'"'*(3 b 6,3("

    %5'$"(*'#Q &'.3$&%+'" #(" #'3("2,5.(" UC 6,3(" ;(&% 3("2,5(" #%"/(" -(#,(" $6(5

    K& X UC_0F[J0Z;c0[5$0K&J8 [5(*6,5$3 #(" -'+(a'"(*'# #(-(5 #'6%+'.(" "(*," 5'#(.

    5%+*(&,. $6(5 -(#,(" &5("#(+Q 6'3( 5%3(4 5%+6,.5' +%&'&5%" *(.( %5(*6,5$3 5'#(.

    #'6%+'.("8UeQOA

    9%"/$6(5(" +%&'&5%" $6(5 /("#( #'6(/' *%"2(#' #,( ;(&% 7('5, ;(&% '"5%"&'; #("

    3("2,5("8 Z(*( ;(&% '"5%"&'; -(#,(" &5("#(+ !"#$"%&'( (#(3(4 6%+#(&(+.(" .$"N%+&'

    6'(.("8 H6(5 &,"5'. #'6%+'.(" &%3(*( ;(&% '"5%"&'; #'5%+,&.(" &%.,+("/0.,+("/"7(

    b 6,3(" (5(, *'"'*(3 1 6,3(" &%5%3(4 .$"N%+&' 6'(.("8 =(*," +%.$*%"#(&' ^RH

    5(4," OAUU *%"7%6,5.(" ;(&% '"5%"&'; 7("/ #'+%.$*%"#(&'.(" -(3'"/ &%#'.'5 C 6,3("8

    9%"#%.(5(" '"#'N'#,(3 5%+*(&,. 4(&'3 6'(.("Q (-,&(" #(4(. >

  • 5/21/2018 PNPK TB

    49/120

    39Pedoman Nasional Pelayanan Kedokteran

    6'(.("8 =(*," ^RH 5(4," OAUU *%+%.$*%"#(&'.(" 5$5(3 3(*("7( -%"/$6(5("

    (#(3(4 -(3'"/ &%#'.'5 OA 6,3("8OQUe

    9%:&%' ;52&%+%

    U8

    Y%"%N(` ^RH 9+%&&f OAUA8

    O8 $+3# R%(354 H+/("'a(5'$"8 (+"(+# MQ ?36%+5 RQ K$%5a%% YQ Hr>+'%" SQ >$&*(" M[Q8 S(-'# *$3%:,3(+ &:+%%"'"/ ;$+

    *,35'#+,/0+%&'&5("5 5,6%+:,3$&'& '" ( 4'/40N$3,*% -,63': 4%(354 3(6$+(5$+7 '" I$,54 ?;+':(8 ?* T

    $; S%&-'+ ("# K+'5 K(+% M%#8 OAACfU@@`@C@0eO8

    UU8 ?*%+':(" ,+*(" Q %5 (3Q8 I5("#(+#'a%# 5+%(5*%"5

    $; (:5'N% 5,6%+:,3$&'& '" -(5'%"5& E'54 -+%N'$,& 5+%(5*%"5 ("#X$+ E'54 *$"$0+%&'&5(":% 5$

    '&$"'(a'#` ( &7&5%*(5': +%N'%E ("# *%5(0("(37&'&8 93$I M%#':'"%8 OAAefbFeJ`%UAAAUDA8

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    '"5%"&'N% -4(&%` -+$*$5'$" $; (#4%+%":%8 !"5 T $;

  • 5/21/2018 PNPK TB

    50/120

    40 TATA LAKSANA TUBERKULOSIS

    54% 0+%3(5%# M'33%""',* G%N%3$-*%"5 Y$(3& OAAb8

    Ub8 S,&%" !G !0P=Q ?3(+:$" [Q >'33$ =Q >'&&%33 PQ >$'33$5 \Q %5 (38 K$:4+("% &7&5%*(5': +%N'%E $;

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    T$,+" $;

  • 5/21/2018 PNPK TB

    51/120

    41Pedoman Nasional Pelayanan Kedokteran

    4"4 N

    (64%#!65K$)$ 0"2" !%"2""' !+6$6$

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    29

  • 5/21/2018 PNPK TB

    52/120

    42 TATA LAKSANA TUBERKULOSIS

    18 >,.5' *'.+$6'$3$/' #(" (5(, 4'&5$-(5$3$/' *%","2,..(" 5,6%+.,3$&'&

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    G'(6%5%& *%3'5,& FGMJ *%+,-(.(" &(3(4 &(5, ;(.5$+ +'&'.$ 5%+&%+'"/ -(#( -(&'%"

    -(+,8 I((5 '"'Q -+%N(3%"& 5%+2(#'"7( -(+, *%"'"/.(5 &%'+'"/ #%"/(" -%"'"/.(5("

    -+%N(3%"& -(&'%" GM8 \+%.,%"&' GM -(#( -(&'%" #'3(-$+.(" &%.'5(+ UA0UDB #("

    -+%N(3%"& -%"7(.'5 '";%.&' '"' O0D .(3' 3%6'4 5'"//' -(#( -(&'%" #'(6%5%& #'6("#'"/.("

    #%"/(" .$"5+$3 7("/ "$"0#'(6%5%&8V

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    -%"/$6(5(" 5,6%+.,3$&'&8 9(&'%" #%"/(" #'(6%5%& *%3'5,& *%*-,"7(' +'&'.$ +%3(5';

    /(6,"/(" .%/(/(3(" #(" .%*(5'(" &%6%&(+ UQbe F!P eDBQ UQVb0OQUOJ8 S'&'.$ +%3(5';

    ,"5,. .%*(5'(" #(3(* -%"/$6(5(" 5,6%+.,3$&'& &%6%&(+ UQCe F!PeDBQ UQDO0OQVbJ8

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  • 5/21/2018 PNPK TB

    54/120

    44 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    55/120

    45Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    56/120

    46 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    57/120

    47Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    58/120

    48 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    59/120

    49Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    60/120

    50 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    61/120

    51Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    62/120

    52 TATA LAKSANA TUBERKULOSIS

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    53Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

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    54 TATA LAKSANA TUBERKULOSIS

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    55Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

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    56 TATA LAKSANA TUBERKULOSIS

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    57Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

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    58 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

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    59Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

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    60 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    71/120

    61Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    72/120

    62 TATA LAKSANA TUBERKULOSIS

    +%&-$"& 5%+4(#(- ("5'6'$5'. #(-(5 *%"/(+(4 .%-(#( 5,6%+.,3$&'& &(3,+(" ,+$/%"'5(38

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  • 5/21/2018 PNPK TB

    73/120

    63Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    74/120

    64 TATA LAKSANA TUBERKULOSIS

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    65Pedoman Nasional Pelayanan Kedokteran

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    67Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

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    69Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

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    70 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

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    71Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    82/120

    72 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    83/120

    73Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    84/120

    74 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    85/120

    75Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    86/120

    76 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    87/120

    77Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    88/120

    78 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    89/120

    79Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    90/120

    80 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    91/120

    81Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    93/120

    83Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

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    84 TATA LAKSANA TUBERKULOSIS

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  • 5/21/2018 PNPK TB

    95/120

    85Pedoman Nasional Pelayanan Kedokteran

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  • 5/21/2018 PNPK TB

    96/120

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    &%:(+( .3'"'& ("(. F-(&'%"J (.(" 5(*-(. &%4(58 P%(#((" '"' #'&%6,5 &%6(/(' '";%.&'

    3(5%"8 =(*," (-(6'3( #(7( 5(4(" 5,6,4 ("(. 3%*(4 #(" 5'#(. *(*-, *%"/%"#(3'.("

    .,*("Q *(.( ("(. (.(" *%"2(#' &(.'5 &%+5( *%","2,..(" /%2(3( .3'"'& #("

    +(#'$3$/'&8 L2' 5,6%+.,3'" +%3(5'; *,#(4 #(" *,+(4Q -%"%3'5'(" *%","2,..(" 6(4E(

    -$5%"&' 5,6%+.,3'" 5%5(- .$"&5(" &%5%3(4 N'(3 #'6,.( &%3(*( U 6,3("8C

    !=\[PI! F Z(5%"J

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    I%3('" ,2' 5,6%+.,3'"Q 6("7(. -%*%+'.&((" #(+(4 7("/ 6%+%#(+ &%:(+( .$*%+&'(3

    #%"/(" 5,2,(" *%"'3(' +%&-$"& '*," 5,6,4 5%+4(#(- &%-%+5' 4(3"7( ,2' 5,6%+.,3'"8

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    ,"//,3 #(+'-(#( ,2' 5,6%+.,3'"8 9%*%+'.&((" ;%-$1

  • 5/21/2018 PNPK TB

    97/120

    87Pedoman Nasional Pelayanan Kedokteran

    L2' 5,6%+.,3'" *%+,-(.(" (3(5 #'(/"$&'& 7("/ -(3'"/ 6('. ,"5,. *%*6,.5'.(" (#("7(

    '";%.&' 8

    9%*%+'.&((" !YS? *%*-,"7(' -$5%"&' .%,"//,3(" #'6("#'"/ ,2' 5,6%+.,3'"Q "(*,"

    &5,#' -(#( ("(. 6%3,* 6("7(.8 R(+/( -%*%+'.&((" !YS? +%3(5'; *(4(3 #(" &((5 '"' 6%3,*

    5%+&%#'( #' !"#$"%&'(8 9%*%+'.&((" &%+$3$/' 5'#(. #'+%.$*%"#(&'.(" -%"//,"((""7( 6('. ,"5,. #'(/"$&5'.

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    9%*%+'.&((" #(+(4 FZ[GQ 3'*;$&'5$&'&J 5'#(. (#( +,2,.(""7(Q #(" 5'#(. #'("2,+.(" #(3(*

    -%#$*(" #'(/"$&'& "(&'$"(3 *(,-," '"5%+"(&'$"(3

    ?%H%,#B(++' J+B*%,#0&0!#(

    #(" !32+5/2-$1"&' -&5$12+0"0 #(+' 6'(.(" (5(, *%5$#% -%*%+'.&((" 3('""7(8

    #%"/(" ;(&'3'5(& 5%+6(5(&8 I-%&'*%" 7("/ 5%-(5 #(+' $+/(" 7("/ 5%+3'6(5 #'%N(3,(&'

    ,"5,. -%*%+'.&((" 6(.5%+'$3$/'& 7('5, #%"/(" -,3(&(" 3("/&,"/ F6"1$2- 0'$/1J ,"5,.

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  • 5/21/2018 PNPK TB

    98/120

    88 TATA LAKSANA TUBERKULOSIS

    &%*,( ,*,+Q #%"/(" 4(&'3 7("/ 3%6'4 6('. #(+'-(#( (&-'+(&' 3(*6,"/Q 5%+,5(*(

    (-(6'3( *%"//,"(.(" 3%6'4 #(+' U &(*-%38 9%*%+'.&((" &(*-%3 #(+' U '"#,.&'

    &-,5,* *%"/4(&'3.(" V .(3' "'3(' -$&'5'; 7("/ 3%6'4 5'"//' #(+'-(#( (&-'+(&'

    3(*6,"/8UVQU1 M%5$#% '"' (*(" #(" +%3(5'; *,#(4 &%4'"//( 6'&( #'.%+2(.("

    -(#( -(&'%" +(E(5 2(3("8 L"5,. *%3(.,.(""7( #'-%+3,.(" -%3(5'4(" #("-%+(3(5(" 7("/ &%#%+4("(8

    ?%H%,#B(++' C#(*08+*0&0!#

    9%*%+'.&((" 4'&5$-(5$3$/' F9?X9(5$3$/' ?"(5$*'J #(-(5 *%*6%+'.(" /(*6(+("

    7("/ .4(&Q 7('5, *%","2,..(" /(*6(+(" /+(",3$*( #%"/(" "%.+$&'& -%+.'2,(" #'

    5%"/(4"7( #(" #(-(5 -,3( #'5%*,.(" /(*6(+(" &%3 #(5'( 3("/4("& #(" (5(, .,*("

    8 >'3( -(#( &,(5, .(&,& 7("/ #':,+'/(' %.&5+(-(+, #(" *%*%+3,.(" 5'"#(.("

    6%#(4 7("/ *%+,-(.(" .%&%*-(5(" 6('. *%"#(-(5.(" &-%&'*%"Q -%*%+'.&(("

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    /0,"1/-"+% 5"+,03\P]XJJ #(-(5 *%*6("5, -%"%/(.(" #'(/"$&'& -(#( ("(.8UD

    ?%H%,#B(++' 10*0 *0,+B(

    9%*%+'.&((" -%","2("/ 3('" 7("/ :,.,- -%"5'"/ (#(3(4 -%*%+'.&((" ;$5$ 5$+(.&8

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    -(#( -%"7(.'5 3('"8 I%3('" '5,Q N(+'(6'3'5(& ("5(+ -%*6(:( 4(&'3 ;$5$ 5$+(.& :,.,-

    6%&(+8UbG%"/(" #%*'.'(" -%*%+'.&((" ;$5$ 5$+(.& &(2( 5'#(. #(-(5 #'/,"(.(" ,"5,.

    *%"#'(/"$&'& Q .%:,(3' /(*6(+(" *'3'%+8 I%:(+( ,*,*Q /(*6(+(" +(#'$3$/'&

    7("/ *%","2("/ (#(3(4 &%6(/(' 6%+'.,5`

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  • 5/21/2018 PNPK TB

    99/120

    89Pedoman Nasional Pelayanan Kedokteran

    ;8 P(N'5(&

    /8

    48

  • 5/21/2018 PNPK TB

    100/120

    90 TATA LAKSANA TUBERKULOSIS

    7" 9>%-,=2>2 .4 ;%B% %,%+ B),-%, 2>2&)1 2+='>,-

    9%"//,"((" &'&5%* &.$+'"/ 6("7(. *%"/,"#("/ .$"5+$N%+&'Q .(+%"( 6%6%+(-(

    &5,#' *%","2,..(" 6(4E( &'&5%* &.$+'"/ :,.,- 6('. "(*," 6("7(. &5,#' 3('"

    7("/ *%"7(5(.(" 6("7(. .%3%*(4(" 7("/ #'*'3'.' &'&5%* &.$+'"/8 >,.5' 7("/ (#(

    *%","2,..(" 6("7(. .%3%*(4(" &'&5%* &.$+'"/8Ue=(*," #%*'.'("Q 5%"(/( .%&%4(5("

    #' 3(7("(" .%&%4(5(" #%"/(" ;(&'3'5(& 5%+6(5(& X 3(7("(" -+'*%+ &%+'"/.(3' *%"/(3(*'

    .%&,3'5(" *%"#'(/"$&'& -(#( ?"(.8 I%3('" .%5%+6(5(&(" (3(5 #'(/"$&'&Q 5'(#("7(

    5%"(/( #$.5%+ 2,/( *%"2(#' .%"#(3( #'(/"$&'& -(#( ("(.8 R(3 '"' *%"7%6(6.("

    6%&(+(" *(&(3(4 -(#( ("(. 5'#(. 5%+#(5( .(+%"( 5%"(/( .%&%4(5(" #' 3(7("("

    .%&%4(5(" -+'*%+ +(/, (5(, .,+("/ -%+(7( #'+' ,"5,. *%"#'(/"$&'& ("(. &%4'"//(

    5%+2(#' &%6$1:6"/@%+0"08 G' &'&' 3('" (/(."7( 2,&5+, 5%+2(#' +*$1:6"/@%+0"0 ("(. #'

    3(7("(" &E(&5( .(+%"( :%"#%+,"/ *%"//(*-("/.("8

    I'&5%* &.$+'"/ #'(/"$&'& ?"(. 7("/ #'&,&," $3%4 9$.2( ?"(. P%*%".%&

    S! #(" !.(5(" G$.5%+ ?"(. !"#$"%&'( F!G?!J *%*6("5, 5%"(/( .%&%4(5(" (/(+

    5'#(. 5%+3%E(5 #(3(* *%"/,*-,3.(" #(5( .3'"'& *(,-," -%*%+'.&((" -%","2("/

    &%#%+4("( &%4'"//( #'4(+(-.(" #(-(5 *%"/,+("/' 5%+2(#'"7( &%6$16"/@%+0"0*(,-,"

    +*$16"/@%+0"08OA

    ?"(. #'"7(5(.(" ,1+5/5#$ 2'.( &.$+'"/ *%":(-(' "'3(' b (5(, 3%6'48 =(*,"

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  • 5/21/2018 PNPK TB

    101/120

    91Pedoman Nasional Pelayanan Kedokteran

    8>2&)1 2+='>,- B>%-,=2>2 .4 !,%+ B> :%2>*>&%2 ;)*%K%,%, +)2)3%&%, ;'>1)'OA

    0%'%1)&)' Y / C F 8+='

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  • 5/21/2018 PNPK TB

    102/120

    92 TATA LAKSANA TUBERKULOSIS

    #%"/(" &'&5%* &.$+'"/ ("(.

    " 9(&'%" ,&'( 6(3'5( 7("/ *%"#(-(5 &.$+ DQ #%"/(" /%2(3( .3'"'& 7("/ *%+(/,.("Q

    *(.( -(&'%" 5%+&%6,5 #'+,2,. .% SI ,"5,. %N(3,(&' 3%6'4 3("2,5

    I'&5%* &.$+'"/ 4("7( #'/,"(.(" #' ;(&'3'5(& .%&%4(5(" -+'*%+ 7("/ 5%+6(5(&Q 6('.

    .%5%+6(5(&(" 5%"(/( *%#'& *(,-," -%+("/.(5 #'(/"$&'&

    P(&,& 7("/ *%+(/,.(" 4(+,& #'+,2,. .% ;(&'3'5(& .%&%4(5(" 7("/ 3%6'4 3%"/.(-

    L"5,. ;(&'3'5(& 3(7("(" .%&%4(5(" 7("/ 3%6'4 3%"/.(-Q &'&5%* &.$+'"/ #(-(5 #'/,"(.("

    &%6(/(' -%"(-'&(" (E(3Q "(*," 4(+,& #'3%"/.(-' #%"/(" -%*%+'.&((" #'(/"$&'& 7("/

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    I%5%3(4 #'"7(5(.(" &%6(/(' -(&'%" -(#( ("(. #(" #'6%+'.(" -%"/$6(5(" H?

  • 5/21/2018 PNPK TB

    105/120

    95Pedoman Nasional Pelayanan Kedokteran

    9" J%,+* $+' ,#'!+''E+ 8%'E+B#*

    U8 +'"/("` 5'#(. 6%+'&'.$ *%"'*6,3.(" .%:(:(5(" 6%+(5 (5(, .%*(5'("Q *'&(3"7(

    -+'*%+ 5("-( .$*-3'.(&'Q .,3'5Q .%3%"2(+ #33

    O8 6%+(5` -(#( ("(. 7("/ 6%+'&'.$ *%"'*6,3.(" .%:(:(5(" 6%+(5 (5(,

    .%*(5'("Q *'&(3"7( *%"'"/'5'&Q *'3'%+Q 5,3("/ #(" &%"#'Q (6#$*%"Q

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  • 5/21/2018 PNPK TB

    106/120

    96 TATA LAKSANA TUBERKULOSIS

    >J #'6("#'"/.(" ("(. 6%&(+

    (5(, #%E(&(8OUQOOT%"'& ("5' 3'"' -%+5(*( #(" #$&'&"7( 5%+:("5,* #(3(* .%()* Z"/"

  • 5/21/2018 PNPK TB

    107/120

    97Pedoman Nasional Pelayanan Kedokteran

    .%()* Z"/" H?< 7("/ #'-(.(' #(" #$&'&"7(

    [%1% @(%&

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    !&$"'(a'# FRJ UA F@0UDJ VAA R%-(5'5'&Q "%,+'5'& -%+';%+Q4'-%+&%"&'5'N'5'&

    S';(*-'&'" FSJ UD FUA0OAJ bAA

    Y(&5+$'"5%&5'"(3Q +%(.&' .,3'5Q

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  • 5/21/2018 PNPK TB

    108/120

    98 TATA LAKSANA TUBERKULOSIS

    &%+5( +%.$*%"#(&' -%*6%+'(" 1 *(:(* H?< -(#( ;(&% '"5%"&'; 5'#(. &%.,(5 -(#(

    $+("/ #%E(&(Q .%:,(3' -(#( >

  • 5/21/2018 PNPK TB

    109/120

    99Pedoman Nasional Pelayanan Kedokteran

    N0,*#B0(*%,0#$

    P$+5'.$&5%+$'# #(-(5 #'/,"(.(" ,"5,. #%"/(" .$*-3'.(&' &%-%+5'f *%"'"/'5'& Q

    &,*6(5(" 2(3(" "(-(& (.'6(5 .%3%"2(+Q #(" -%+'.(+#'5'& 8 9(#( .$"#'&' *%"'"/'5'&

    6%+(5 .$+5'.$&5%+$'# *%"'"/.(5.(" &,+N'N(3 #(" *%",+,".(" *$+6'#'5(&Q &%4'"//(

    .$+5'$&5%+$'# #'("2,+.(" -(#( .(&,& *%"'"/'5'& 8ODI5%+$'# #(-(5 -,3( #'6%+'.("

    -(#( *'3'%+ #%"/(" /("//,(" "(-(& 7("/ 6%+(5Q %;,&' -3%,+( #(" (6#$*%"

    #%"/(" (&'5%&8 H6(5 7("/ &%+'"/ #'/,"(.(" (#(3(4 -+%#"'&$" #%"/(" #$&'& O */X./X

    4(+'Q &(*-(' 1 */X./X4(+' -(#( .(&,& &(.'5 6%+(5Q #%"/(" #$&'& *(.&'*(3 bA */X4(+'

    &%3(*( 1 *'"//,Q .%*,#'(" -/,,$1"%@:+

  • 5/21/2018 PNPK TB

    110/120

    100 TATA LAKSANA TUBERKULOSIS

    9%*6%+'(" *(.("(" 5(*6(4(" &%6('."7( #'6%+'.(" #%"/(" *(.("(" 7("/ *,#(4

    #'5%+'*( ("(. #(" 6%+N(+'(&'8 T'.( 5'#(. *%*,"/.'".(" #(-(5 #'6%+'.(" &,-3%*%"5(&'

    ",5+'&' &(*-(' ("(. &5(6'3 #(" #(-(5 #' (5(&'8

    ?#,#$0B(#'

    #%"/(" *(3",5+'&' 6%+(5 #(" ("(. #%"/(" R!W 7("/ *%"#(-(5.(" ?SW8 I,-3%*%"5(&'

    -'+'#$.&'" FD0UA */X4(+'J #'+%.$*%"#(&'.(" -(#( 6(7' 7("/ *%"#(-(5 ?I! %.&3,&';Q

    R!W -$&'5'; (5(, *(3",5+'&' 6%+(58O

    9" .%&% *%+2%,% ):)+ 2%1;>,- =(%&

    [;%. &(*-'"/ $6(5 3%6'4 2(+("/ 5%+2(#' -(#( ("(. #'6("#'"/.(" #%E(&(8 9%*6%+'("

    %5(*6,5$3 ,"5,. ("(. 7("/ *%"/(3(*' 6%+(5 5'#(. 6("7(. *%"'*6,3.(" /%2(3(

    %;%. &(*-'"/ &%3(*( -%*6%+'(""7( &%&,(' #%"/(" +%"5("/ #$&'& 7("/ #'+%.$*%"#(&'8O@

    [;%. &(*-'"/ 7("/ -(3'"/ -%"5'"/ (#(3(4 4%-(5$5$.&'&'5(&Q 7("/ #(-(5 #'&%6(6.("

    $3%4 '&$"'(a'#Q +';(*-'&'" (5(, -'+(a'"(*'#8 ["a'* 4(5' 5'#(. +,5'" #'-%+'.&(Q -(#(

    .%(#((" -%"'"/.(5(" %"a'* 4(5' +'"/(" 5("-( /%2(3( .3'"'& F.,+("/ #(+' D .(3' "'3('

    "$+*(3J 6,.(" *%+,-(.(" '"#'.(&' -%"/4%"5'(" 5%+(-' $6(5 ("5' 8 T'.( 5'*6,3 /%2(3(4%-(5$*%/(3' (5(, '.5%+,& 4(+,& &%/%+( #'3(.,.(" -%"/,.,+(" .(#(+ %"a'* 4(5' #("

    2'.( -%+3, -%"/4%"5'(" $6(5 8 9%"(-'&(" .% (+(4 -%"7%6(6 4%-(5'5'& 3('" 4(+,&

    #'3(.,.("8 H6(5 #'6%+'.(" .%*6(3' 2'.( ;,"/&' 4(5' .%*6(3' "$+*(3Q #'6%+'.("

    #%"/(" #$&'& 7("/ 3%6'4 .%:'3 #(3(* +%"5("/ 5%+(-'Q #%"/(" 5%5(- *%*$"'5$+ .(#(+

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  • 5/21/2018 PNPK TB

    111/120

    101Pedoman Nasional Pelayanan Kedokteran

    %;%. *%"/,"5,"/.(" #(" #'.4(E(5'+.(" #(-(5 *%"'*6,3.(" >KY0'5'& #'&%*'"(5(Q

    7('5, -%"7(.'5 (.5'; (.'6(5 -%*6%+'(" >KY -(#( -(&'%" '*,"$.$*-+$*(&8

    ^RH *%"%5(-.(" 6(4E( N(.&'"(&' >KY *%+,-(.(" .$"5+('"#'.(&' -(#( ("(.

    5%+'";%.&' R!W 7("/ 6%+/%2(3(8 R(3 '"' &%+'"/ *%"2(#' #'3%*( 6'3( 6(7' *%"#(-(5>KY &%/%+( &%5%3(4 3(4'+ -(#( &((5 &5(5,& R!W0"7( 6%3,* #'.%5(4,'8 >'3( &5(5,& R!W

    '6, 5%3(4 #'.%5(4,' #("F1$*$%-"%@ !+-9$1 -+ =9"#6 71/%0'"00"+% +

  • 5/21/2018 PNPK TB

    112/120

    102 TATA LAKSANA TUBERKULOSIS

    (5(, 5'#(. 5%+'";%.&' F,2' 5,6%+.,3'" "%/(5';J8 9(#( ("(. #%"/(" .$"5(. %+(5 7("/

    .%-(#( ("(.0("(. #%"/(" 6,.5' '";%.&' F,2' 5,6%+.,3'" (5(, !YS? -$&'5';J "(*,"

    5'#(. 5%+#(-(5 /%2(3( #(" 5("#( .3'"'& 8OQ VU

    G$&'& #(" 3(*( -%*6%+'(" !=R &(*(#%"/(" -%":%/(4(" -+'*%+8

    ("(. 6(3'5( #(" ("(. '*,"$.$*-+$*('& #' &%/(3( ,&'( 7("/ .$"5(. %+(5 #%"/("

    -(&'%" >

  • 5/21/2018 PNPK TB

    113/120

    103Pedoman Nasional Pelayanan Kedokteran

    #-1-2=- 2==2Z= 2%< E7$1

  • 5/21/2018 PNPK TB

    114/120

    104 TATA LAKSANA TUBERKULOSIS

    /45 Y?%21< ;6: U2#$+P A!: Y$2E?% *O5 '7- 372#82E?"$%-+$E= 2%< 372#82E?

  • 5/21/2018 PNPK TB

    115/120

    105Pedoman Nasional Pelayanan Kedokteran

    K#1"')$"$) O"'1 (%#5)4"(

    U8 P%*%"5+'(" P%&%