Tuberculosis — the RIPE therapy and the toxicity

The RIPE therapy — confirm the 2-month intensive plus 4-month continuation regimen, doses and observation requirements against local TB guidelines; the held reference covers drug-resistant TB management.^[2]

The toxicity of each drug — confirm hepatitis, neuropathy/pyridoxine, hyperuricaemia/gout, optic-neuritis monitoring and CYP450 interactions against local TB guidelines; the held reference covers drug-resistant TB (prolonged 9–24 month regimens with less favourable outcomes).^[2]

The MDR-TB — resistance to rifampicin and isoniazid needs a specialist second-line regimen over a prolonged course (globally 4.6% of TB, exceeding 25% in Kazakhstan, Kyrgyzstan, Moldova and Ukraine; treatment prolonged 9 to 24 months with less favourable outcomes than drug-susceptible disease).^[2]

The principles: drug-susceptible regimen per local guidelines with liver/vision monitoring; specialist referral for MDR — confirm all specifics against local TB guidelines.^[2]