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Diagnosed for TB and started treatment. Screening test showed negative. Is it necessary to take medicine?

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Practicing since : 1979
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hi sir, I have been diagnosed for TB and started taking treatment, my four and half year child is with me, dr advised to screen my daughter with CXR and TST. dr concluded that nothing to worry after seeing the cxr report and TST. but dr prescribed to take R-cin 150mg and INH 75mg for 6 months. Though screening tests are negative Is it necessary for her to take this medicine. kindly let us know your valuable suggestions. Thanks.
Posted Thu, 30 Aug 2012 in Cancer
Answered by Dr. Shashi Dangwal 1 hour later

Thanx for posting your query on XXXXXXX

You have not mentioned as to you are suffering from tb of which organ? I presume it is of lungs because mostly only tb of lung is infectious. The chances of infection increase if one is sputum positive ie one`s sputum contain tb bacteria.

Your daughter has been screened and presently she has been found disease free. Though free of disease at present she may still have been infected and may develop disease later on. That`s why your doctor has suggested R-cin and INH for her. This is called prophylactic treatment.

I`m also of the opinion that she should be given the treatment because at times tb can develop complications esp in children with bad prognosis.

I hope i`ve been able to answer your query and it is of help .
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Follow-up: Diagnosed for TB and started treatment. Screening test showed negative. Is it necessary to take medicine? 12 minutes later
Thanks for the reply. Rightly you have presumed pulmonary TB.

My question is whether she has to take both R-cin and INH? or INH alone?
because some protocol says INH alone is fine for prophylactic treatment.

second, How long she has to continue the medication and dosage of INH & R-cin?
Answered by Dr. Shashi Dangwal 2 hours later

Yes, you are right-most protocols recommend INH alone as prophylaxis, but since chances of drug resistant tb(incase tb comes up again in future) increase if treated with only one drug, i recommend giving two most effective tb drugs ie INH and Rifampicin. For the same reason, it is better to continue treatment for 6 months though various studies say that 4 months are sufficient.

If you have any more queries, i will be pleased to answer them.
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Follow-up: Diagnosed for TB and started treatment. Screening test showed negative. Is it necessary to take medicine? 53 minutes later
Thanks for the reply.
still i need one clarification.
If we take treatment as per the INH/R-cin 6 months schedule for chemo-prophylaxis,

Are there any chances for her to have active TB after this INH/R-CIN treatment?

In case if yes whether R-cin will become resistant during that time?
Answered by Dr. Shashi Dangwal 1 hour later

The chemoprophylaxis being given now is to prevent development of tb disease as a result of tb infection that your daughter may have contracted as a result of being exposed to you.

The possibility of a person getting infected again by tb bacteria any time during his/her lifetime always remains irrespective of the fact that he/she has had tb and taken treatment for it.

The chances of tb bacteria becoming resistant to a particular drug are more if the patient has been exposed to that drug in the past especially if the treatment has been irregular in terms of dosage, duration and continuity. That`s why the stress is on taking proper treatment as then bacteria are unable to develop resistance and in future same medicine can be used if required.

The dosage of R-cin is 10 mgm/kg body weight and of INH is 5 mgm/kg body weight.
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