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Have TB. Prescribed Levoflox, PAN-D. Is there a better a medication? What is the period of medication?

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Practicing since : 2003
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if the person is suffering from lung TB then which course he/she should opt for going with . We Consulted 2 doctors and they were of the opinion that 1st One prescribed AKT-4, Levoflox -500mg, PAN-D, FEFOL , and 2nd doctor prescribed R-Cinex-600 , Combutol -600, Pyzina-750, Pan 40 . Can you pls. suggest which one i should go with. also pls mention what are the period of the medication to be take in each option. what are the side effects from this treatment.

Posted Fri, 13 Apr 2012 in Lung and Chest disorders
Answered by Dr. Gyanshankar Mishra 4 hours later

Thanks for posting your query.

After going through your query, I would like to comment the following:

1. The patient seemd to be diagnosed as a case of lung TB (Pulmonary Tuberculosis).

2. If the sputum examination was positive for TB on microscopy, then a sputum culture & drug sensitive testing for TB. If sputum smear was negative then a broncho alveolar lavage (BAL) sample should be sent for the same examination. If all the above tests are negative then TB may be diagnosed on clinical history along with radiological picture (xray/ CT scan) and other supportive evidence.

3. The use of second line anti tb drug (like levoflox- 500 mg) without culture sensitivity testing is usually not recommended. Hence first regime is not proper.

4. Now for TB occurring for the first time the second regime seems to be ok as the choice of the drugs is considered, however if you can tell me the age, gender and weight of the patient, I can comment on the correctness of the doses of the anti tb drug regime. Rcinex, Combutol & Pyzina generally are required to be taken for 2 to 3 months depending on the clinical response and then it is followed by a 4 month course of Rcinex. Also please note that you need to take all these drugs at the same time of the day.

5. Also you need to take tablet pyridoxine 10 mg daily throughout the treatment. You may also take an anti acidity medication like PAN D along with anti TB drugs for prevention of drug induced acidity.

6. Also the following baseline testing before starting anti tb drugs need to be done:
a. Liver function test
b. Kidney function tests (Blood urea & serum creatinine)
c. Serum TSH levels
d. Serum uric acid
e. Eye checking for colour blindness

7. Common side effects of anti tb drugs are nausea, vomitiing & burning pain in abdomen. Some uncommon side effects include development of joint pains, jaundice, colour blindness, leg swelling, thyroid imbalance, etc. If you notice any of these effects during the course of therapy please consult your physician immediately.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
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