A primigravida in first trimester was observed to be sputum positive for acid fast bacilli. She had no previous history of tuberculosis. Which of the following should be the treatment strategy?
The patient in the clinical scenario is a sputum positive newly diagnosed case thus belongs to the category I. Patients in this category are given Rifampicin / Ethambutol / Isoniazid / Pyrazinamide for 2 months followed by Rifampicin/Isoniazid thrice weekly for 4 months. All the above mentioned drugs can be safely used in pregnancy. While streptomycin, ethionamide and fluroquinolones are teratogenic. Ref: Emerging Infections in Asia By Yichen Lu, Max Essex, Bryan Robes, Pages 217-219; Park textbook of preventive and social medicine 21st edition Page 173.
Category I DOTS
Category II DOTS
Category III DOTS
Defer treatment