A 26 year-old seasonal worker from South America came to the ER with a history of a dry, hacking blood-tinged cough, fever, chills, and loss of appetite. The chest x-ray showed cavitary lesion in the right upper lobe
After a week in the hospital, the sputum culture shows the present of acid-fast stained organisms. Which of the following medications would you recommend for this patient at this time?
1. Ceftizoxime
2. Isoniazid
3. Rifampin
4. Ethambutol
a. 1 only
b. 2 and 4 only
c. 1, 2, and 3 only
d. 2, 3, and 4 only
ANS: D
Isoniazid, rifampin, pyrazinamide, and ethambutol are first-line antituberculous medications. Pending antimicrobial susceptibility results; treatment with four drugs at the outset is recom-mended. In those with drug-susceptible pulmonary tuberculosis, a number of 6- to 9-month treatment regimens have been shown to be effective as outlined in the ATS/CDC/IDSA guide-lines.
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