How Long Should One Continue Rifampicin And Levofloxacin?

Posted on Thu, 21 May 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 21 May 2015 Answered on

Thu, 11 Jun 2015 Last reviewed on

Question : Hi Doctor,

How long will my mother needs to continue Rifamcin and Levofloxacin?
Also her eyes have healed about 50%. But still she cannot read newspapers or read from television. How long will it take?
We checked with an Orthopedic Surgeon for the backpain issue and he confirmed it to be a muscle sprain.(Last question which we discussed)

Thanks and Regards,XXXX XXXXXXX

Answered by Dr. Divakara (4 hours later)

Brief Answer:
She can stop Rifampicin.

Detailed Answer:
Hi

Greetings from Dr. Divakara. P
Thanks for posting your query.

Answering your query regarding the duration for Rifampicin and Levofloxacin a total duration of 9-12 months has to be taken.

I think she has taken Rifampicin for more than 12 months but Levofloxacin has to be taken for 6-8 months ( I have considered 2 months of ofloxacin and 2 months of Levofloxacin)

Coming to the issue of her vision I think its difficult to tell when she will get back her vision and whether she will get back her vision completely.

Kindly let me know when was her last MRI and eye examination done last.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Divakara (20 minutes later)

Hi Doctor,

1) She has taken Ofloxacin for 8 months and Levofloxacin for 4 months
2) Rifamcin- She has taken for 11 months
3) MRI report for eyes were done in the month November when she developed the issue. It said very less Retrobulbar Neuritis(according to the Opthalmologist at XXXXXXX Nethralaya. Also all the other tests done were perfect without any issues).
4) She has diabetes but fully controlled.

Thanks and Regards,
XXX XXXXXXX

Answered by Dr. Divakara (4 hours later)

Brief Answer:
She can stop Levoflox but continue Rifampicin for 1 month

Detailed Answer:
HI

Thanks for the information.

Well 8 months of Oflox and 4 months of Levoflox , that's a total of 12 months of Quinolones so she can stop taking Levoflox. As of Rifampicin is concerned let her take it for 1 more month and then stop.

I would recommend a repeat MRI to check if the Retro bulbar Neuritis has totally subsided ( in that case we need to search for other cause of Visual impairment) or not, also kindly repeat her Eye check up . ( Ask for a Flurorescein Angiography test )

I would recommend you consult your treating Physician before stopping Rifampicin and let him examine for the lymph nodes that were enlarged before starting Tubercular treatment and make sure ( by doing a repeat FNAC/Biopsy test ) that TB has been cured.

If she is declared cured of TB and if there is Retrabulbar Neuritis persisting she can be started on Steroids.( Steroids can't be started if TB is still active )

Hope this information helps you.
Any clarifications feel free to ask .

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Divakara (2 hours later)

Hi Doctor,

She was given corticosteriods last November for 1 month. After not much improvement she was asked by the opthalmologist to stop it.
The Medicine specialist asked her not to take any drugs for eyes as it will be cured over long time. Only thing she was asked to control diabetes which she is doing very well.

Thanks and Regards,
XXX XXXXXXX

Answered by Dr. Divakara (11 minutes later)

Brief Answer:
3 months of steroid treatment may show some effect.

Detailed Answer:
Hi

Thanks for the information.

Well one month of steroid treatment is very less to comment, at least 3 months have to be observed. Well that was just a opinion.

Regards.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar