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Suggest Treatment For TB Infection In Semen

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Posted on Thu, 16 Apr 2015
Question: Dear Sir,

Iam in treatment of male infertility treatment . During my treatment, i was diagnosed of having semen TB through semen PCR TB analysis.
Afterwards i started treatment ( as per doctor advice ) with AKT 4 tablets (1 Big tablet - Ethambutol Hydrochloride – after brush in empty stomach , 2 (tabs) - pyrazinamide,1 (cap) - rifampicin before breakfast ,I had after tea )and benadon 40mg ( half tablet after breakfast ).
Just a day before i completed my 02months AKT course. AT end of 45 days , i repeated Liver function test,which is okay.
Now i was advised to take Rcin 300mg ( 01 tablet after brush )and benadon 40mg ( half tablet after breakfast ) for another 04 months.
Afterwards he advised me o repeat liver function test for further medicine ( may be another 03 months ).
Whether i am in right treatment .
doctor
Answered by Dr. Swarnava Dattagupta (2 hours later)
Brief Answer:
YOUR TREATMENT IS GOING IN THE RIGHT DIRECTION

Detailed Answer:
Hello.

This is Dr. Swarnava Dattagupta answering your query.

I understand your concern.

It's unfortunate that you have been diagnosed with tuberculosis. But let me assure you that it is totally curable.
Now, you are being treated appropriately. It is a 6 month course of tubercular drugs considering the response is encouraging. The LFT is done basically to check the liver status as the drugs are basically toxic to liver. Also, benadon or vit b6 is given to reduce chances of peripheral neuropathy which is a complication of isoniazid.
Now, your case is a new case or what we call Category 1 case. So in it the drug regimen is divided into 2+4 months which exactly you are having.
So dont worry, continue the drugs and hopefully the followup reports will come as negative and eventually your treatment will be successfully completed.

Hope I have answered your question.
Contact me for further queries.
Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Swarnava Dattagupta (28 minutes later)
Hai doctor,

Thanks for your encouraging reply.
Doctor advised me not to reputation of semen pcr test after treatment.because the test will show positive only,even though bacteria is ruled out.

Whether i had taken right sequence of AKT 4 tablets ( both in empty stomach, before breakfast , had after tea ) and after breakfast, which i mentioned in last one. All the sequence was advised by doctor.

Please advise.
doctor
Answered by Dr. Swarnava Dattagupta (13 minutes later)
Brief Answer:
YES RIGHT SEQUENCE WAS MAINTAINED

Detailed Answer:
Hello again.

What we generally say is take rifampicin tablets before breakfast (empty stomach) and the rest after breakfast. Some doctors have other regimens. But the one thing that matters is the regularity of the dosage that is you need to take the drugs at the same scheduled time throughout your treatment duration.
So if you have followed his instructions regularly, then there should be no problem. Take the rest of the schedule on time. You can take rifampicin before food and the rest, after breakfast. But its better to stick to your original schedule which you have followed so far.
And yes, i meant to say LFT reports by the follow up reports being negative; if its in normal range or negative, there is no chances of hepatotoxicity.

Take care.
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Swarnava Dattagupta (20 minutes later)
Thanking you.

After the treatment, he is advising me not to repeat the semen pcr test. If tested also, he is telling it will shOw pOsitive Only.

NOw iam taking rifampicin at empty stomach and benedon after food. AKT4 treatment over. Now my confusion over on AKT 4 dosage which i got confuse with seeing internet. Whether iam going in wrong

It is okay
doctor
Answered by Dr. Swarnava Dattagupta (7 minutes later)
Brief Answer:
DONT WORRY, YOUR TREATMENT IS GOING IN THE RIGHT WAY

Detailed Answer:
Hello again.

Your doctor has rightly ruled out the requirement of a repeat PCR. Just get your LFT done to rule out hepatotoxicity. Hopefully, it wont be there, but even the results are slightly altered, they can be reversed back to normal in some time with medication.
And as i had said earlier, dont worry, your regimen is going in a proper way. Just continue rifampicin and pyridoxin for the remaining period in the same way you had been doing. Trust me, if taken regularly and according to advice, the outcome of tuberculosis treatment is really good. Dont be confused by any other information.

Hope this was helpful.
Wish you good health.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Swarnava Dattagupta (10 hours later)
Thanks doctor.
And i said early, i am confused of the sequence of taken AKT 4 tablet ( i.e not taking rifampicin in empty stomach ).
Since i am in aboard, all the tablets are received my brother from doctor ( Andrology department ) and sending to me.For any side effects management, i am consultanting doctor here.
your answer made me relaxed and i am continuing the remaining.

IS THERE ANY SPECIFIC REASON THAT DOCTOR ADVISED ME FOLLOW AKT4 IN THAT SEQUENCE.
doctor
Answered by Dr. Swarnava Dattagupta (1 hour later)
Brief Answer:
NOTHING SPECIFIC; DONT WORRY

Detailed Answer:
Hello again.
No I don't think there was any specific reason behind your regimen. And the regimen varies from doctor to doctor but are very authentic. But one thing we all stress upon is regularity. And you have maintained the regularity well.
If you had been given wrong schedule, altered test results could have come.

So you need not worry. Your treatment is going well.

Regards.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Swarnava Dattagupta (20 minutes later)
Thanks again.altered results ,that u mentioning LFT
doctor
Answered by Dr. Swarnava Dattagupta (4 minutes later)
Brief Answer:
YES LFT

Detailed Answer:
Hello.
Yes you are right. I meant LFT.
Relax.
You are in very able hands.

Wish you good health.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Swarnava Dattagupta (45 hours later)
Thanks Doctor,

Regarding the schedule timing of tablet , Iam taking AKT 4 tablets in following timing:
A. (1 Big tablet - Ethambutol Hydrochloride – after brush in empty stomach
B. Afterwards 15-20minutes, i am having tea.
C. After 1-1and half hour, i am having remaining 03 tablets( (tabs) - pyrazinamide,1 (cap) - rifampicin )
D. Afterwards breakfast and benadon 40mg ( half tablet after breakfast ).

Is the timing is fine or not.
Because of timing, is there any chance of reduce in reaction of tablet or chance of DR-TB.

Sorry sir, iam totally confused
doctor
Answered by Dr. Swarnava Dattagupta (1 hour later)
Brief Answer:
FOLLOW ADVICE, DONT PANIC

Detailed Answer:
Hello.
I understand your concern.

As I have told you before, we tend to give rifampicin in empty stomach and the rest after breakfast. Your doctor given you another schedule which is equally effective. There is no chance of treatment failure because of that.
But if you still feel confused, take rifampicin in empty stomach and the rest after breakfast. It is a very well known schedule advised for TB patients.
Otherwise, you can continue your previous schedule also. No problem with that.

Hope this was helpful.
Regards
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Swarnava Dattagupta (7 minutes later)
Thanks for your clarification.
As I told before , my AKT4 schedule over.
Now iam taking follow up treatment contains rifampicin in empty stomach and benadon ( 0.5 tablet ) after food.

I will continue the same.
doctor
Answered by Dr. Swarnava Dattagupta (27 minutes later)
Brief Answer:
CONTINUE THE SAME

Detailed Answer:
Hello.
Yes do continue the same and complete your course.

Wish you good health.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Swarnava Dattagupta (19 hours later)
Good morning sir,
Yesterday my brother check With My doctor ( Andrology ) who is giving treatment for me. Further to discussion with him, the outcomes are :

01. It was found out, the nurse given the wrong guidance of taking AKT 4 tablet sequence , as i explained in previous discussion.
02. Doctor confirming that No problem of taking the tablet in the sequence i taken. Both will have the same effect. He advised to continue the following course ( Rcin and benadon ) and complete the 4 month course. No need to take tension on AKT 4 issue.
He also added that as per government guidance that all tablets to be taken in morning or before breakfast inorder to continue the course in effective way.

Please guide me.

doctor
Answered by Dr. Swarnava Dattagupta (30 minutes later)
Brief Answer:
DONT WORRY DEAR

Detailed Answer:
Hello.
Good morning.

Yes dear, as I have told you earlier, you need not worry. Just complete your treatment. I have also talked to my fellow doctors and all of them are of the same opinion as mine. Unless you have not been irregular with your course, before or after breakfast dosage won't alter treatment results. Government rules say to take them together as there are many illiterate patients who will find it convenient to take them all together at a certain time of the day. So you can see, time does not matter that much, regularity does.
So just relax.
You have simply nothing to worry.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Swarnava Dattagupta (1 hour later)
Thanking you once again.

Allmy worries have been ruled out.

Thanks for giving mental strength and to get ride off my negative thought.

Sir, Is there is any chance of spreading of TB bacteria viua sexual contact with my wife. ( as i detected TB in semen ). Presently, i had only one time sex with condom.

Please guide me
doctor
Answered by Dr. Swarnava Dattagupta (49 minutes later)
Brief Answer:
HAVE SEX WITH PROTECTION

Detailed Answer:
Hello.

It's good to make you free from worries.
And yes, I do understand your concern.

Genital TB though rare can spread through sexual contact. But as you are being treated properly for tuberculosis, it is unlikely to spread the disease in this situation. But still as a precaution, have sexual contact with condoms on and after you finish your drug course for TB, you may have normal sexual contact thereafter.

Wish you good health.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Swarnava Dattagupta

General & Family Physician

Practicing since :2013

Answered : 906 Questions

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Suggest Treatment For TB Infection In Semen

Brief Answer: YOUR TREATMENT IS GOING IN THE RIGHT DIRECTION Detailed Answer: Hello. This is Dr. Swarnava Dattagupta answering your query. I understand your concern. It's unfortunate that you have been diagnosed with tuberculosis. But let me assure you that it is totally curable. Now, you are being treated appropriately. It is a 6 month course of tubercular drugs considering the response is encouraging. The LFT is done basically to check the liver status as the drugs are basically toxic to liver. Also, benadon or vit b6 is given to reduce chances of peripheral neuropathy which is a complication of isoniazid. Now, your case is a new case or what we call Category 1 case. So in it the drug regimen is divided into 2+4 months which exactly you are having. So dont worry, continue the drugs and hopefully the followup reports will come as negative and eventually your treatment will be successfully completed. Hope I have answered your question. Contact me for further queries. Regards.