01-01-2009, 08:17 PM
e
Multi-drug resistant TB is an emerging problem in the USA. If the organisms are resistant to both rifampin and INH, we call it a multi-drug resistant TB (MDR-TB). In case of exposure to MDR-TB, chemoprophylaxis with pyrazinamide and ethambutol or quinolone with anti-mycobacterial activity, like ofloxacin or levofloxacin is recommended. But, if it is resistant to INH only, as in our case, then the standard recommendations are to give the chemoprophylaxis with Rifampicin alone for four months or Rifampicin plus PZA for two months. The problem with the rifampin plus PZA combination in an immunocompetent host is liver toxicity. The patient needs careful monitoring.
Multi-drug resistant TB is an emerging problem in the USA. If the organisms are resistant to both rifampin and INH, we call it a multi-drug resistant TB (MDR-TB). In case of exposure to MDR-TB, chemoprophylaxis with pyrazinamide and ethambutol or quinolone with anti-mycobacterial activity, like ofloxacin or levofloxacin is recommended. But, if it is resistant to INH only, as in our case, then the standard recommendations are to give the chemoprophylaxis with Rifampicin alone for four months or Rifampicin plus PZA for two months. The problem with the rifampin plus PZA combination in an immunocompetent host is liver toxicity. The patient needs careful monitoring.