A 37-year-old lady, complained of pain in right hypochondrium. USG was done - parietal abscess was found. The fluid was tapped, sent for cell count and culture. It was AFB positive, normal four drugs therapy was started on 9 March. Pain decreased but not relieved. Culture report came around 20 April. Bacilli were found to be resistant to INH and streptomycin. Patient from 25 April started on rifampin 750 mg, Ethambutol 1200, pyrazinamide 2, Levofloxacin 750. Slight improvement in pain.
In meanwhile patient becomes diabetic, metformin was started. Pyrazinamide was stopped on 26 June due to itching. She started having knee joint pain, Levofloxacin stopped on 30 August. Now the abscess has resolved, appetite, normal. When should we stop ethambutol and Rifampicin+ Isoniazid? 12 months since she started. Her sugar is controlled. When to stop?
