Strengthening Perioperative TB Pathways: A Narrative Review on the Interprofessional Triad of Internists, Pediatric Surgeons, and Pharmacists

Mirza Adhyatma; Mohammad Rizki Fadhil Pratama; Yhohan Ziantprayogi Thaihutu

doi:10.33084/jsm.v12i1.13777

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Published: Aug 13, 2026

DOI: https://doi.org/10.33084/jsm.v12i1.13777

Keywords:

Tuberculosis Perioperative Care Pediatric Surgeon Internist Pharmacist

Mirza Adhyatma

Universitas Muhammadiyah Palangka Raya

Mohammad Rizki Fadhil Pratama

Universitas Muhammadiyah Palangkaraya

https://orcid.org/0000-0002-0727-4392

Yhohan Ziantprayogi Thaihutu

Universitas Muhammadiyah Palangka Raya

https://orcid.org/0009-0002-6375-1840

Abstract

Extrapulmonary and surgical manifestations of tuberculosis (TB), such as abdominal TB, tuberculous lymphadenitis, and spinal TB, present complex clinical challenges that require interventional precision and rigorous pharmacotherapy. The management of these cases across pediatric and adult populations necessitates a seamless continuum of perioperative care. This narrative review highlights the vital collaborative triad among internists, pediatric surgeons, and pharmacists in optimizing perioperative TB pathways. Pediatric surgeons perform diagnostic biopsies, surgical debridement, and anatomical management in young patients, whereas adult presentations, systemic complications, and chronic comorbidities are managed by internists. Pharmacists serve as the critical integrative link across pre-, intra-, and postoperative stages, evaluating anti-TB drug absorption post-surgery, adjusting dosages for organ dysfunction, managing complex drug-drug interactions with anesthetic or immunosuppressive agents, and monitoring for anti-TB drug-induced hepatotoxicity. This interprofessional synergy ensures continuity of care, minimizes perioperative drug-related harm, and enhances long-term treatment adherence during pediatric to adult patient transitions. This collaborative framework mitigates the risks of surgical treatment failure and drug resistance by combining surgical expertise, internal medicine oversight, and clinical pharmacotherapy stewardship. Institutionalizing formal interprofessional communication and perioperative protocols is essential for strengthening global TB outcomes.

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Adhyatma, M., Pratama, M. R. F., & Thaihutu, Y. Z. (2026). Strengthening Perioperative TB Pathways: A Narrative Review on the Interprofessional Triad of Internists, Pediatric Surgeons, and Pharmacists. Jurnal Surya Medika (JSM), 12(1). https://doi.org/10.33084/jsm.v12i1.13777

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Vol. 12 No. 1 (2026): Jurnal Surya Medika (JSM)

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Articles

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Author Biographies

Mirza Adhyatma, Universitas Muhammadiyah Palangka Raya

Faculty of Medicine, Universitas Muhammadiyah Palangkaraya, Indonesia

Mohammad Rizki Fadhil Pratama, Universitas Muhammadiyah Palangkaraya

Faculty of Pharmacy, Universitas Muhammadiyah Palangkaraya, Indonesia

Yhohan Ziantprayogi Thaihutu, Universitas Muhammadiyah Palangka Raya

Faculty of Medicine, Universitas Muhammadiyah Palangkaraya, Indonesia

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