[Anti-tuberculosis chemotherapy and management of adverse reactions]

Six-month regimen consisting of two-month initial intensive phase of isoniazid (INH), rifampicin (RFP), pyrazinamide (PZA) and ethambutol, (or streptomycin) and four-month maintenance phase of INH and RFP has been established as the global standard. Alternatively, 9-month regimen without PZA is acceptable for patients like elderly persons. Standard regimen is well tolerated in most patients. However some patients have adverse reactions. The frequent and serious reaction is hepatic toxicity caused by INH and PZA. Close monitoring of serum aminotransferase at every two weeks of initial treatment phase is recommended. Hypersensitivity to INH and RFP is common reaction seen in 4-5 percent of the general population. About 60-80% patients who had hypersensitivity can continue the standard regimen by desensitization therapy.