Is it treatment fallacy for P.TB? ?Progressed to MDR TB

This 65 year old male patient who has been on Akurit-4 2 tabs empty stomach for last 8 months from elsewhere Chief Complaints He reports to OPD with complaints of regurgitation, acidic mouth, and epigastric discomfort from last few weeks History Known case of T2DM but well controlled His recent TLC in early march were raised to about 12000 He was never microbiologically confirmed TB, he was always treated on the basis of HRCT thorax, during 8 months of ATT he was subjected to CT twice, both of which had similar findings, no change Management Though he has been prescribed PPI+ Prokinetic, along with OADs by me I would like to know, how should I intervene such report of trace and intermediate?


Genexpert confirms tuberculosis and resistant to rifampcin He may be a c/o MDR and need CAT2 Simultaneously control gastric complaints by iv fluids ppis and antacids Since pt is diabetic screen for LFTS and pancreatitis

Thanx dr Uday Kumar M.s Natesan

Multidrug-resistant (MDR) tuberculosis (TB) (defined as resistance to at least isoniazid and rifampicin), has a relevant epidemiological impact,  Delamanid and bedaquiline .

Classical case of MDR. Since inspite of completr treatment no response. You can do Sputum for AFB. Go for 2nd line of drugs according to the culture report. Some times going back to the time old S.M 0.75 gm alternate days ma help.

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8 months of antituberculosis treatment Still sputum test positive for tuberculosis It is likely to be drug resistant Tuberculosis Before changing medication it is important to get culture and sensitivity report, without report it will not be appropriate to treat him Adv Sputum for TB culture for three consecutive days

Could be reactivation of TB. Send sample for TB PCR study.

Isomer poly chain reaction is confirmatory test for Tuberculosis

The usual treatment is: 2 antibiotics (isoniazid and rifampicin) for 6 months. 2 additional antibiotics (pyrazinamide and ethambutol) for the first 2 months of the 6-month treatment period. CDC: TB treatment can now be done in 3 months. Treatment of latent TB infection should start after excluding the possibility of TB disease. Groups Who Should be Given High Priority for Latent TB Infection Treatment include: People with a positive TB blood test (interferon-gamma release assay or IGRA).

May be Iatrogenic ? Wrong diagnosis & tt? Report posted not significant? To continue same tt as u adviced......LFT ,Stool R/E to exclude worm infestations?

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