How Long Do Anti-tubercular Treatment For Abdominal TB Take To Be Effective?
Better to add moxifloxacin
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
You are a case of extra-pulmonary tuberculosis (Gastro-intestinal TB). Duration of Anti-tubercular treatment for abdominal TB is 9 months -12 months (3 EHRZ + 6 HR in your case ).
Duration of Anti-TB treatment(ATT) is optimum in your case. However since you have taken under dose (Adult dose : 25 mg/kg/kg orally daily) of pyrazinamide (Z)750 mg once a day instead of the correct dose of 750 mg twice a day for initial 1.5 months, there are possibilities that you developed resistance to that drug. You are now on HR (INH 300 mg + Rifampicin 600 mg) for next 06 months.I would rather add Tablet Moxifloxacin (400 mg) a second-line anti-tubercular drug along with HR for next 06 months, since your pyrazinamide was suboptimal dose initially.A fluoroquinolone(Moxifloxacin) will strengthen the ATT regimen . Continue Benadon along with HR.
What is your present body weight?Regaining body weight would be a sign of recovery.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
My doctor said, as i took underdose of pzide for 1.5months, he extended duration of pzide to 3.5 months instead of 2 months as standard practice. Do you think I should start Moxifloxacin for next 6 months? is there a way I could be sure that pzide did not completed its job?
Anti-TB treatment(ATT) -introduction of 2nd line drug
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
In fact,there is no way now to know whether mycobacterium tuberculosis was susceptible to Pyrazinamide(PZA) during 3.5 months of treatment with that drug along with Ethambutol(E),INH(H) & RIF(R). Since there is a possibility of PZA resistance in your case,at this stage addition of fluoroquinolone(Moxifloxacin) for next 06 months would be justified.
Regards
Dr. T.K. Biswas M.D. XXXXXXX