I am taking treatment for tuberculosis. I am taking medications from the past 3 months. In the beginning doctor gave the following medication (for 8 days) 1. Rifampicin - 450 mg 2. Ethambutol - 600 mg 3. Isoniazid - 200 mg 5. Benadon - 20 mg 6. Pyrazinamide - 1000 mg then liver got affected so he put me on this for a week (7 days) (i got drug induced hepatitis) 1. Ethambutol - 600 mg 2. Levoflox 750 mg 3. Injection amikacin 500m mg (iv) then again for one week (7 days) he gave, 1. Ethambutol - 600 mg 2. Levoflox 750 mg 3. Injection amikacin 500m mg (iv) 4. Isoniazid - 100 mg taking isoniazid again affected the liver, so he stopped isoniazid and he gave this for 5 weeks, 1. Ethambutol - 600 mg 2. Levoflox 750 mg 3. Injection amikacin 500m mg (iv) then when the liver condition became ok, doctor has given the following medication 1. Rifampicin - 450 mg 2. Ethambutol - 600 mg 3. Isoniazid - 200 mg 4. Benadon - 20 mg 5. Levoflox 750 mg this is what is going on now. I am not sure if the treatment being given is right or not. I had consulted another pulmonologist who says this is not the right treatment as drugs should not be changed so often. Also he says amikacin and levoflox are given for mdr tb and not for normal tb. Now that it is already given I cannot change that. The other pulmonologist says that if it is these drugs then one needs to give it for 9 months as pyrazinamide is not given. He also says if sputum is negative then we can stop levofloxin and give the drugs for 4 months. However I am not getting sputum for testing also. I have two questions now. 1. Other than sputum testing is there any other way of finding out if tb bacteria is still there in the body. If that is the only way is there any way of generating sputum. 2. Should att-4 with the four standard medications be started again. What is the best alternative. Kindly suggest.
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You are now tolerating isoniazid rifampicin along with ethambutol levoflox and inj amicin. Ethambutol and isoniazid dose is less and one should reintroduce pyrazinamide and see if you can tolerate hypertonic saline nebulization can be tried for sputum induction if not successful then bal.
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Pulmonologist altered regimen and added levofloxacin because you had liver side effects with pyrazinamide which was stopped the standard regimen of rifampicin isoniazid ethambutol pyrazinamide is a guideline with exception when necessary it is not an inviolable dictate still in doubt consult pulmonologist at nationaltb institute bangalore malleswaram.
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