Pulmonary TB

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High -AFB index. Plan 4 drugs AKT. If extensive and severe form, may consider adding streptomycin. Send sputum CBNAAT and AFB culture sensitivity test to rule out MDR TB. Can give benadon 40 od. Akurit 4 ,2 tabs are enough. No need of adding levoflox at present.

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This patient has very active tuberculosis, please send sputum for AFB culture and sensitivity He is currently on two tablets of Akurit 4 per day Each tablet of Akurit 4 contain Isoniazid (75mg)+ Rifampicin (150mg)+ Ethambutol (275mg)+ Pyrazinamide (400mg) So the patient received double the dose Actual required dose Isoniazid 5 mg/kg = 150 mg per day, two tablet of Akurit 4 contain 150 mg Isoniazid Rifampicin 10 mg/ kg = 300 mg, two tablets of Akurit 4 contain 300 mg Rifampicin Ethambutol 15 - 20 mg/kg = max 600 mg , two tablets of Akurit 4 contain 550 mg Pyrazinamide 25 mg/kg = 750 mg Two tablets of Akurit 4 contain 800 mg So the dose received in two tablets of Akurit 4 is adequate

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In view of reasonably high AFB index, it is advisable to continue full adult dose ..Add streptomycin.also.. No other Cephalosporin or Quinoline antibiotic required to add. Milk/Fruit/Adequate neutrons care.

Thank you doctor
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My concerns are - I read that as the weight is above 25kgs, so should initiate ATT as per Adult FDC as per weight, so I advised him to take two tabs of Akurit 4, Am I on the right track? Kindly guide me Secondly, regarding Benadon 40mg, should I give half or complete tab to the patient? Regarding Levofloxacin, Do u advise adding levoflox to the ATT regimen? @Sandeep Ghodekar @Dr. Suranjana Basak @Jayesh Kalbhande Please guide me in these context

I6 YEARS MALE 30 KG WEIGHT SPUTUM FOR A F B POSITIVELY WITH SIEL NELSONS STAIN 3 TIMES UNDER WT STRAT HIM.ON.ATT DOT TT ETHUMBUTAL ON ETHUMBUTAL TRESTMENTBDO EYE EXAMINATSTION AS ETHUMBTAL HAS OCULAR TOXICITY

Shifting on CAT2

Thanx dr Sandeep Ghodekar
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You are right

Thank you doctor
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High AFB index Active case of pul kochs Adv: 4 drug AKT If req add inj streptomycin

NEED'S.. AKT4 KIT ..

agree with @Dr. Sandeep Ghodekar

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