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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For MDR TB

Hi my husband has been suffering from MDR TB ND he does not have many medicines working on him(Only 2) Nd now he seems to even b resistant by them as the government had giving him the wrong medicines in Mumbai. Is there any private doctor he can be cured by now. Please thee me the name of the best doctor in India im ok with traveling as well but wont him to live as he is only 21 yrs.
Thu, 31 Jul 2014
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General & Family Physician 's  Response
Hello
Since your husband is just 21 years old and developed M D R TB .
But don't desperate your husband will be alright . I am prescribing a full treatment .Be careful that don't stop this treatment before 30 months time . If any MEDICINE don't adjust at once inform .
Since your husband is just 21 years so I am giving complete detail.
MDR bacilli & MDR tuberculosis :MDR bacilli are resistant to at least ISONIAZIDE & RIFAMPICIN, the main anti tubercular drugs.
MDR is the most severe form of bacterial resistance today.
1 Streptomycin 15 mg / kg body weight for 3 months I M injection , painful but apply heparin locally with ice sponging.
OR
KANAMYCIN OR AMIKACIN
2 Ehionamide 10-20 mg / kg body weight .
3 Pyrazinamide 20-30 mg / kg body weight .
4 Levofloxacin 10-15 mg / kg body weight once in day.
5 Ethmbutol 15-20 mg / body weight
6 Cycloserine 10-20 mg / kg body weight .
Usually few doctor advise PAS also but I don't like.
Now how I adjust these drugs to my patient .
1 Injection streptomycin 1 gm ( weight wise) I M / day , but if patient feel any dizziness or vertigo . Stop at once.
2 Tablet ehionamide + cycloserine 250 mg+ pyrazinamide 750 mg, each twice in a day ( morning & evening ) with pantaloc-d .
3 Levofloxacin 750 mg in the night after meal with clonazepam 0.25 mg for first 10-15 day and thereafter on alternate day only clonazepam . Levofloxacin continue till 30 months.
4 Tablet ethmbutol 800 mg once in day at 12 noon once in day for 3 months .
If your husband is having breathlessness ( asthma ) then add monteleukast+ bambuterol , once in the night.
Add antacid + high protein diet like cheese ,milk .
Although patient will feel nausea and vomiting many times but ondansetrone will help.
I also advise Ringer lactate IV drip + cynacobalamine 2ml ( 3-4 amp in each bottle ) on alternate day for 10 day means 5 bottles in all.
Before I V drip lung capacity ( pulmonary function test ) should be checked.
Hope this will help you . Good luck for your husband.

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Suggest Treatment For MDR TB

Hello Since your husband is just 21 years old and developed M D R TB . But don t desperate your husband will be alright . I am prescribing a full treatment .Be careful that don t stop this treatment before 30 months time . If any MEDICINE don t adjust at once inform . Since your husband is just 21 years so I am giving complete detail. MDR bacilli & MDR tuberculosis :MDR bacilli are resistant to at least ISONIAZIDE & RIFAMPICIN, the main anti tubercular drugs. MDR is the most severe form of bacterial resistance today. 1 Streptomycin 15 mg / kg body weight for 3 months I M injection , painful but apply heparin locally with ice sponging. OR KANAMYCIN OR AMIKACIN 2 Ehionamide 10-20 mg / kg body weight . 3 Pyrazinamide 20-30 mg / kg body weight . 4 Levofloxacin 10-15 mg / kg body weight once in day. 5 Ethmbutol 15-20 mg / body weight 6 Cycloserine 10-20 mg / kg body weight . Usually few doctor advise PAS also but I don t like. Now how I adjust these drugs to my patient . 1 Injection streptomycin 1 gm ( weight wise) I M / day , but if patient feel any dizziness or vertigo . Stop at once. 2 Tablet ehionamide + cycloserine 250 mg+ pyrazinamide 750 mg, each twice in a day ( morning & evening ) with pantaloc-d . 3 Levofloxacin 750 mg in the night after meal with clonazepam 0.25 mg for first 10-15 day and thereafter on alternate day only clonazepam . Levofloxacin continue till 30 months. 4 Tablet ethmbutol 800 mg once in day at 12 noon once in day for 3 months . If your husband is having breathlessness ( asthma ) then add monteleukast+ bambuterol , once in the night. Add antacid + high protein diet like cheese ,milk . Although patient will feel nausea and vomiting many times but ondansetrone will help. I also advise Ringer lactate IV drip + cynacobalamine 2ml ( 3-4 amp in each bottle ) on alternate day for 10 day means 5 bottles in all. Before I V drip lung capacity ( pulmonary function test ) should be checked. Hope this will help you . Good luck for your husband.