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Pulmonary tuberculosis — SCE Respiratory MCQ

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EasyRespiratory InfectionsPulmonary tuberculosisSCE Respiratory

A 38-year-old man has cough, night sweats and weight loss. CXR shows right upper-zone cavitation; sputum smear is positive for acid-fast bacilli and NAAT confirms fully drug-susceptible Mycobacterium tuberculosis. HIV test is negative. What is the most appropriate management?

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Correct answer: C — Rifampicin, isoniazid, pyrazinamide and ethambutol initially, then rifampicin and isoniazid continuation

Drug-susceptible pulmonary TB is treated with standard four-drug intensive therapy followed by rifampicin and isoniazid continuation. Isoniazid monotherapy is for selected latent TB, not smear-positive pulmonary disease, and macrolide-based regimens are used for some NTM disease. Treatment should not wait for final culture when smear and NAAT confirm TB.

Reference: NICE NG33; BNF