Antituberculous Medications and Development of Jaundice/Abnormal Liver Function Tests

IF A CHILD ON ATT HOW TO FOLLOW:

1. CHECK BASELINE LFTs after 2-4 weeks of ATT

    LFTs are normal—Normal LFT no follow up needed.

    LFTs are abnormal—Check LFTs every 2 weekly for 8 weeks.

2. If ALT >2 time UNL ---------------------Check LFT 2 time/weekly till normal.

3. If ALT >3 time UNL With symptoms/ >5 time UNL without symptoms then STOP ATT 

    ( all drugs) & START 2nd LINE ATT—till normalization of LFT(ALT<2 time normal).

4. When LFTs are normalized (normalized ALT <2 time UNL), then RESTART RIFAMPICIN (NOTE: start with low dose of rifampicin then gradually increase over a week)

(LOOK FOR RIFAMPICIN TOLERANCE)

5. AFTER 3-7 DAYS RESTART INH ---------IF SYMPTOM REAPPEAR REMOVE LAST DRUG.

6. IN CASE OF PROLONGED SEVERE HEPATOTOXICITY DO NOT USE PZA BUT ADD OTHER DRUG LIKE CYCLOSERINE, ETHAMBUOL.

7. (NO DERRANGED LFTS) CONTINUE Rx