Which antitubercular drug combination is safer in a patient who develops hepatitis white on ATT: March 2005

Ans. B: Streptomycin+Ethambutol Hepatitis is a major side effect of isoniazid, pyrazinamide and rifampicin. In case hepatitis develops, all these drugs should be stopped and S+E may be staed or continued. When the reaction clears, the above drug is added one by one to identify the culprit, which should never be used again, while the others found safe should be continued. It is best to avoid Pyrazinamide in patients who once developed hepatitis.