Which anti-tubercular drug combination is safer in a patient who develops hepatitis while on ATT?
Streptomycin and Ethambutol are the only antitubercular drugs which have no hepatotoxicity thus are safer in a patient who develops hepatitis while on ATT as they dont have hepatic metabolism and are excreted by kidneys only. IMPOANT POINTS ABOUT FIRST LINE ATT: Drug Action Hepatotoxic Bacteria Inhibited Isoniazid CIDAL Yes Both Rifampicin CIDAL Yes Both Pyrazinamide CIDAL Yes Intracellular Ethambutol STATIC No Both Streptomycin CIDAL No Extracellular
Streptomycin + Isoniazid
Streptomycin + Ethambutol
Ethambutol + Isoniazid
Ethambutol + Rifampicin
Mycobacterial Diseases (TB, Leprosy and MAC)