Can we we give INH and Rif to INH and R resistant strains in combination with other std. regimen H,R,E,P?
Using INH and Rif in the same patient is not recommended as they are already resistant. There will no use, but they may increase the toxicity. Better treatment is to use other combination drug regimen.
Thank you Dr. santosh, One doctor was argued with me that even in resistant cases also H and R can be given. And after that I have read many books, searched internet but i didn't find any answer for that.
If either one drug is resistance i.e. H or R then , remaining first line(3 drugs) of drugs should be given.
If H and R both are resistance to m. tb , then it is called "Multidrug resistance TB", treatment for MDR- DOTS PLUS ..6 drugs in intensive phase, 4 drug in continuation phase for 18 months after culture conversion
6 drugs- ethambutol, pyrazinamide
one of aminoglycoside- kanamycin/amikacin
one of Fluroquinolones- levo/moxi floxacin
one or more of injectable - cycloserine/ethionamide
You should go with following weblinks and web documents:
http://health.bih.nic.in/Docs/Guidelines-DOTS-Plus.pdf or
http://www.who.int/tb/publications/2010/9789241547833/en/
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