TB antibiotic regimes
For active TB:
- rifampicin (with pyridoxine) + isoniazid for 6 months
- pyrazinamide + ethambutol for 1st 2 months
or, to rephrase,
- RHZE for 2 months
- continue with rifampicin and isoniazid for another 4 months
For latent TB:
- 3 months isoniazid (with pyridoxine) and rifampicin — typically given to people younger than 35 at low risk of hepatotoxicity.
- 6 months isoniazid (with pyridoxine) — typically given when rifamycin drug interactions may be a concern (e.g. people with HIV or transplant recipients).
Classic TB drugs side effects
- Rifampicin: urine discolouration. Also a CYP450 inducer.
- Isoniazid: Peripheral neuropathy, hepatotoxicity → prophylactic pyridoxine. Also a CYP450 inhibitor
- Pyrazinamide: hepatitis, gout
- Ethambutol: optic neuropathy