A 3-year-old child had contact with a patient diagnosed to have sputum positive pulmonary tuberculosis Later it was found that contact was a proved case of MDR TB. The child spends few days with the patient. Will you put him on INH prophylaxis? Current RNTCP guidelines say no need to put on INH prophylaxis. MDR TB means the TB bacilli he coughs out is resistant to INH and Rifampicin. We use INH 10 mg per kg for six months as prophylaxis.
We are giving Prophylaxis for preventing this baby developing clinical problems due to the Bacillus he has likely contracted from a patient which is resistant to INH. So what is the point in unnecessarily giving a drug to the baby, which you are sure won't work? Agreed. There are studies where six months of preventive therapy with Ofloxacin, Ethambutol, and high dose INH effective in under five children contacts with MDR TB. Many of these studies…
