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How Long Should One Continue Levofloxacin - 750 Mg?
Question: How long will she continue with levofloxain - 750 mg? How long will TB drugs continue for her?
Brief Answer:
For around 1 year.
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney.
I understand your concern.
As far as the first part of your query is concerned she may regain her eye sight completely depending on the severity of the Retro bulbar neuritis she had. If that was mild we expect that her blurring should get normal within a year of stopping Ethambutol.
Now about the Treatment part. In case of Extra pulmonary Tuberculosis ATT is continued for 9-12 months. In her case it will be given for 12 months as her course was interuptted due to Ethambutol related Bulbar Neuritis.
I couldn't however understand why she is being given both Ofloxacin and Levofloxacin.
We usually give one of them mostly Levofloxacin.
After completing 2 months of Isoniazid,Rifampicin , Ethambutol, Pyrazinamide +/- Levofloxacin we continue just Isoniazid, Rifampicin +/- Levofloxacin for remaining 7-10 months.
For her Gastritis issues you can give her a combination of Pantoprazole and Domperidone.
I suppose your doctor must have prescribed her Pyridoxine (Benadon) along with ATT during the whole course as it is essential to prevent a side effect of Isoniazid that is Peripheral Neuropathy.
I hope it helps.
Stay Healthy
For around 1 year.
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney.
I understand your concern.
As far as the first part of your query is concerned she may regain her eye sight completely depending on the severity of the Retro bulbar neuritis she had. If that was mild we expect that her blurring should get normal within a year of stopping Ethambutol.
Now about the Treatment part. In case of Extra pulmonary Tuberculosis ATT is continued for 9-12 months. In her case it will be given for 12 months as her course was interuptted due to Ethambutol related Bulbar Neuritis.
I couldn't however understand why she is being given both Ofloxacin and Levofloxacin.
We usually give one of them mostly Levofloxacin.
After completing 2 months of Isoniazid,Rifampicin , Ethambutol, Pyrazinamide +/- Levofloxacin we continue just Isoniazid, Rifampicin +/- Levofloxacin for remaining 7-10 months.
For her Gastritis issues you can give her a combination of Pantoprazole and Domperidone.
I suppose your doctor must have prescribed her Pyridoxine (Benadon) along with ATT during the whole course as it is essential to prevent a side effect of Isoniazid that is Peripheral Neuropathy.
I hope it helps.
Stay Healthy
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi Doctor,
Thanks for your answer.
1) Retrobulbar neuritis is of very low intensity as written in MRI report. MRI report also confirmed that nothing else has been damaged due to TB Meningitis.
2) Opthalmic doctors have done all possible tests at XXXXXXX Nethralaya and had declared her fundus of eye to be perfect. No other issues of any damage was detected
3) She has regained around 30% of her vision(Q. How much time will it take for her to regain her vision fully?)
4) She has stopped taking Ethambutol and Isoniazid four months back at once when her vision was being affected
5) The Medicine specialist whom we are consulting is a very XXXXXXX physician in XXXXXXX and was head of Department of Medicine, NRS Medical College- He told us that no medicine in quinol group can be continued for more than four months he gave Ofloxacin, Mixifloxacin(stopped due to retrobulbar neuritis) and then levofloxacin.
6) Levofloxacin is giving her pain to her joints but doctor tells that it needs to be continued as all other first line and second line drugs are discontinued.
7) No Pyridoxine was given but he constantly told my mother to consult an ophthalmologist if any vision changes occur.
Thanks for your answer.
1) Retrobulbar neuritis is of very low intensity as written in MRI report. MRI report also confirmed that nothing else has been damaged due to TB Meningitis.
2) Opthalmic doctors have done all possible tests at XXXXXXX Nethralaya and had declared her fundus of eye to be perfect. No other issues of any damage was detected
3) She has regained around 30% of her vision(Q. How much time will it take for her to regain her vision fully?)
4) She has stopped taking Ethambutol and Isoniazid four months back at once when her vision was being affected
5) The Medicine specialist whom we are consulting is a very XXXXXXX physician in XXXXXXX and was head of Department of Medicine, NRS Medical College- He told us that no medicine in quinol group can be continued for more than four months he gave Ofloxacin, Mixifloxacin(stopped due to retrobulbar neuritis) and then levofloxacin.
6) Levofloxacin is giving her pain to her joints but doctor tells that it needs to be continued as all other first line and second line drugs are discontinued.
7) No Pyridoxine was given but he constantly told my mother to consult an ophthalmologist if any vision changes occur.
Brief Answer:
Get her serum uric acid test and give her pyridoxine.
Detailed Answer:
Hello,
No one can say how much recovery of her vision she will have but she will surely have some recovery slowly and gradually. I have seen in my carrier complete recoveries in a course of 1 year after stopping the offending drug in case of Retrobulbar Neuritis.
Her ATT would be required to be continued to atleast 1 year. Now,as far as her joint pains are concerned, you should once get her serum uric acid test done, if not done yet. Pyrazinamide is known to cause elevation of serum uric acid and joint pains but since it is not in action now, so chances are less likely but still, it was given earlier, so it should be given in consideration.
Pyridoxine has to be given with isoniazid. They might have given it earlier. In case not give, you should now give her a good multivitamin supplement.
As far as your main query is concerned, Levofloxacin needs to be continued for a total duration of ATT of 1 year.
I hope it helps.
Stay Healthy.
Get her serum uric acid test and give her pyridoxine.
Detailed Answer:
Hello,
No one can say how much recovery of her vision she will have but she will surely have some recovery slowly and gradually. I have seen in my carrier complete recoveries in a course of 1 year after stopping the offending drug in case of Retrobulbar Neuritis.
Her ATT would be required to be continued to atleast 1 year. Now,as far as her joint pains are concerned, you should once get her serum uric acid test done, if not done yet. Pyrazinamide is known to cause elevation of serum uric acid and joint pains but since it is not in action now, so chances are less likely but still, it was given earlier, so it should be given in consideration.
Pyridoxine has to be given with isoniazid. They might have given it earlier. In case not give, you should now give her a good multivitamin supplement.
As far as your main query is concerned, Levofloxacin needs to be continued for a total duration of ATT of 1 year.
I hope it helps.
Stay Healthy.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi Doctor,
1) Uric Acid test shows normal. Done two weeks before.
2) Why there is a change that full recovery of vision may not occur? She is taking all precautions and medicines.
She is taking a medicine Astymin C Forte. Is this a vitamin medicine?
Thanks and Regards,
XXXXXX XXXXXXX
1) Uric Acid test shows normal. Done two weeks before.
2) Why there is a change that full recovery of vision may not occur? She is taking all precautions and medicines.
She is taking a medicine Astymin C Forte. Is this a vitamin medicine?
Thanks and Regards,
XXXXXX XXXXXXX
Brief Answer:
Yes, that is a multivitamin.
Detailed Answer:
Hello,
If Uric Acid is normal, then no need to repeat it.
There is permanent damage a lot many times due to retrobulbar neuritis and optic neuritis, so full recovery is variable.
Yes, that is a multivitamin, she may continue it.
I hope it helps.
Yes, that is a multivitamin.
Detailed Answer:
Hello,
If Uric Acid is normal, then no need to repeat it.
There is permanent damage a lot many times due to retrobulbar neuritis and optic neuritis, so full recovery is variable.
Yes, that is a multivitamin, she may continue it.
I hope it helps.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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