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Tuberculosis — SCE Infectious Diseases MCQ

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EasyTuberculosisTuberculosisSCE Infectious Diseases

A 30-year-old Indian-born man presents to the TB clinic with a 4-week history of cough, weight loss, and night sweats. Sputum smear shows acid-fast bacilli. Chest X-ray shows right upper lobe cavitation. GeneXpert MTB/RIF detects Mycobacterium tuberculosis complex with no Rifampicin resistance. HIV test is negative. Baseline liver function and renal function are normal. What is the standard initial treatment?

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Correct answer: D — Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol for 2 months then Rifampicin and Isoniazid for 4 months

Standard treatment for drug-susceptible pulmonary TB per NICE NG33 is 2 months of Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol (RHZE) followed by 4 months of Rifampicin and Isoniazid (RH). Total duration is 6 months. Ethambutol is included in the initial phase to cover the possibility of Isoniazid resistance until full susceptibilities are available. Pyridoxine should also be prescribed to prevent Isoniazid-related peripheral neuropathy.

Reference: NICE NG33 2016 (updated 2019) – Tuberculosis