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TB Drug Reactions — SCE Infectious Diseases MCQ

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HardTuberculosisTB Drug ReactionsSCE Infectious Diseases

Two weeks after starting rifampicin, isoniazid, pyrazinamide and ethambutol, a patient develops fever, facial oedema, widespread rash, eosinophilia and hepatitis. What is the safest immediate strategy?

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Correct answer: B — Interrupt all four drugs pending urgent assessment by the TB service

This is a severe systemic drug-hypersensitivity phenotype. During multidrug TB therapy, clinical frequency alone cannot safely identify one culprit. Potentially causative drugs should be interrupted and the TB team should coordinate assessment, alternative cover and any staged reintroduction after recovery; unstructured single-drug guessing risks progression or loss of effective therapy.

Reference: NICE NG33: Tuberculosis — recommendations. https://www.nice.org.uk/guidance/ng33/chapter/recommendations