A 27-year-old woman with laparoscopically confirmed genital tuberculosis is started on antitubercular chemotherapy. According to standard first-line therapy, the correct regimen and total duration are:

• A Isoniazid and rifampicin alone for nine months
• B Streptomycin daily for twelve months
• C Six months of all four first-line drugs given together
• D Two months of isoniazid, rifampicin, pyrazinamide, and ethambutol followed by four months of isoniazid and rifampicin ✓

Explanation

Standard short-course chemotherapy comprises an intensive phase of four drugs, isoniazid, rifampicin, pyrazinamide, and ethambutol, for two months, followed by a continuation phase of isoniazid and rifampicin for four months, totalling six months. Two-drug therapy risks resistance, continuing all four drugs for six months adds toxicity without benefit, and prolonged streptomycin monotherapy is obsolete and ototoxic.

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

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