A 26-year-old woman with genital tuberculosis is started on antitubercular therapy. Which regimen represents the standard initial intensive phase recommended by WHO and followed in Indian practice?

• A Isoniazid and rifampicin for 2 months
• B Rifampicin, pyrazinamide, and levofloxacin for 4 months
• C Streptomycin, isoniazid, and ethambutol for 3 months
• D Isoniazid, rifampicin, pyrazinamide, and ethambutol for 2 months ✓

Explanation

The standard short-course regimen begins with an intensive phase of four drugs, isoniazid, rifampicin, pyrazinamide, and ethambutol, for 2 months, followed by a continuation phase of isoniazid and rifampicin, giving a total of at least 6 months. Streptomycin is no longer part of first-line therapy because of ototoxicity and widespread resistance. Fluoroquinolones belong to multidrug-resistant regimens only.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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