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Rifampicin-resistant tuberculosis — SCE Respiratory MCQ

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HardTuberculosis and NTMRifampicin-resistant tuberculosisSCE Respiratory

A 52-year-old woman with pulmonary TB remains smear-positive after two months of therapy. Molecular testing now identifies rifampicin resistance, and she has previously been treated for TB abroad. She is clinically stable but has cavitary upper-lobe disease. Her teenage son is a close household contact. What is the most appropriate management?

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Correct answer: B — Refer urgently to an MDR-TB specialist service and public health team

Rifampicin resistance defines a high-risk drug-resistant TB pathway requiring specialist MDR-TB management and public health action. Simply adding a macrolide is inadequate and may worsen resistance patterns. Household contacts need coordinated assessment because transmission risk persists while smear-positive.

Reference: NICE NG33 Tuberculosis; BTS MDR-TB Clinical Advice Service