Commonly used antituberculous drugs
The table-1 clearly illustrates the drugs, their dosages and adverse effects.
Treatment recommendations for the various forms of tuberculosis
The consensus statement of the IAP working group is Monotherapy has no
1. Group 1 (Prevention therapy) _ 6HR
a) Asymptomatic Mantoux positive < 3 years
b) Asymptomatic Mantoux positive < 5 years with Grades III, IV PEM
Asymptomatic Mantoux +ve implies that the
patient has no tuberculous lesion and only a tuberculin positivity.
c) Recent converter to Mantoux +ve without signs (Healed lesion: Normal CXR/Calcification/Fibrosis)
d) Children < 3 years of age with history of contact
e) Children < 5 years of age with history of contact with PRIM III & IV
2. Group 2 _ 2 HRZ/4HR
a) Primary complex (Lungs)
b) Symptomatic mantoux +ve < 3 years without localization
c) Symptomatic mantoux +ve < 5 years without localization
with PEM Gr III, IV
d) Isolated lymphadenitis
e) Pleural effusion
3. Group 3 _ 2HRZE/4 HR(extend HR to 7 months if there is no improvement)
a) Progressive pulmonary disease
b) Multiple tuberculous lymphadenitis.
4. Group 4 _ 2HRZE/7HR
a) Miliary / Disseminated TB
b) Bronchopneumonia / cavity
c) Abdominal, pericardial, genitourinary disease, osteoarticular
5.Group 5 _ 2HRZE / 10 HRE
Neurotuberculosis
Special situations:
I. Baby born to mother with tuberculosis (Diagnosed in 3rd Trimester)
- To continue breast feeding
- BCG must be given
- If chest x-ray is normal, to give 6 HR
- If chest x-ray is abnormal, to give 2HRZ/
- 4HR.
II. Congenital tuberculosis - 2HRZ/7HR
Table-1
Sl. No. Name of drug Daily dosage Main adverse effects (mg/kg/d)
01 Isoniazid (H)+ 5 Hepato toxicity
02 Rifampicin ® 10 Hepato toxicity
03 Pyrazinamide (Z) 30 Hepato toxicity
04 Ethambutol (E) 15 Visual disturbance
05 Streptomycin (S) 15 Ototoxicity, Nephro
Toxicity
1. + Newer < 5mg/kg; to be rounded off to the closest higher value
2. All drugs should be administered in a single daily dose on empty stomach
3. Drug is safe, if used in recommended dosage schedule.
4. Vit B6 is not necessary in children on INH.
Comments
Very simple, informative and good coverage of the topic.
Dr S krishnan
Apollo-Hyderabad