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Suggest Treatment For Lymphnode Tuberculosis
Question: Hi , My Mother is 53 Year Old & recently Diagnosed with Lymphnode TB , size of Nodule is 3 cm x 2.7 cm x 2 cm .
she is been taking FORECOX 150 mg TDS after one in the Morning , one in Afternoon & Last One in Night ( Composition is Rifampicin 150 , Isoniazid 100 , Pyrizinamide 500 & ethambutol 275 mg) as per the Physician
She is also taking Levofloxacin 500 OD .
Shall I continue with the treatment or should take One more Opinion .
Does she require any Needle aspirations or removal of Nodules but Pain & swelling in Nodes is reducing Now & after 7 days of treatments she started feeling relieved .
Pl response at the earliest .
Thanks
she is been taking FORECOX 150 mg TDS after one in the Morning , one in Afternoon & Last One in Night ( Composition is Rifampicin 150 , Isoniazid 100 , Pyrizinamide 500 & ethambutol 275 mg) as per the Physician
She is also taking Levofloxacin 500 OD .
Shall I continue with the treatment or should take One more Opinion .
Does she require any Needle aspirations or removal of Nodules but Pain & swelling in Nodes is reducing Now & after 7 days of treatments she started feeling relieved .
Pl response at the earliest .
Thanks
Brief Answer:
take forecox 3 tablets togather.
Detailed Answer:
Hello dear ,thanks for your question on HCM.
I want to know the weight of your mother as dose of anti TB drugs is according to weight. This is to prevent under dosing.
Another thing I would like to comment is timing of forecox. Ideally anti TB drugs (AKT) should be taken togather, not like you are giving.
If we give all the drugs togather at optimal dose, the therapeutic level in the body will be highest and so the anti TB action will be best and fast. So take 3 tablets of forecox togather in morning on empty stomach.
Along with AKT you should also give her multivitamin containing pyridoxine (vitamin B6). This will improve the immunity and fasten the recovery.
Also give her antacid (proton pump inhibitor) one in the morning before AKT to prevent AKT induced gastritis and vomiting.
No need to give cefuroxime. It has no effect on TB Bacilli.
Continue levoflox for 2 months. No need to continue till 6 months.
Also start low dose statin (lipid lowering agent) as her cholesterol is slightly elevated.
And since she is responding to the treatment, no need for needle aspiration or biopsy.
So take AKT at a time in morning, avoid splitting of doses. And complete the minimum six months of treatment.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your mother.
Thanks.
take forecox 3 tablets togather.
Detailed Answer:
Hello dear ,thanks for your question on HCM.
I want to know the weight of your mother as dose of anti TB drugs is according to weight. This is to prevent under dosing.
Another thing I would like to comment is timing of forecox. Ideally anti TB drugs (AKT) should be taken togather, not like you are giving.
If we give all the drugs togather at optimal dose, the therapeutic level in the body will be highest and so the anti TB action will be best and fast. So take 3 tablets of forecox togather in morning on empty stomach.
Along with AKT you should also give her multivitamin containing pyridoxine (vitamin B6). This will improve the immunity and fasten the recovery.
Also give her antacid (proton pump inhibitor) one in the morning before AKT to prevent AKT induced gastritis and vomiting.
No need to give cefuroxime. It has no effect on TB Bacilli.
Continue levoflox for 2 months. No need to continue till 6 months.
Also start low dose statin (lipid lowering agent) as her cholesterol is slightly elevated.
And since she is responding to the treatment, no need for needle aspiration or biopsy.
So take AKT at a time in morning, avoid splitting of doses. And complete the minimum six months of treatment.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your mother.
Thanks.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks Doctor ,
Weight of My mother is 60 kg
My doctor has prescribed Forcox 150 3 tablets to be taken together earlier ,but mother complaint of Acidity & Vertigo so he has suggested to take TDS in split doses to avoid any complication & make the treatment acceptable , Now I am taking another opinion from Dr. XXXXXXX G Raval , MD DTDC at XXXXXXX
He has suggested to change Forcox 150 mg to AKURI T4 3 tablets together 2 hour later dinner .
would it be advisable from your End to shift the Medication from Forecox to Akuri T4 ( as there is little less pyrazinamide & Isoniazid than Forecox 150 mg)
Also pl suggest me if she can take the medicine with Milkh .
Dr. Raval is telling that he has written Zedocef o (Cefpodoxime -Ofloxacin) as USG neck is showing abscess in the Nodules , so to check if any other secondary infection is there
& the last as she has already completed 12 days of treatment in split doses - what are the chances of Resistance .
Should i Go for any Culture Examination to Check MDR -TB
Weight of My mother is 60 kg
My doctor has prescribed Forcox 150 3 tablets to be taken together earlier ,but mother complaint of Acidity & Vertigo so he has suggested to take TDS in split doses to avoid any complication & make the treatment acceptable , Now I am taking another opinion from Dr. XXXXXXX G Raval , MD DTDC at XXXXXXX
He has suggested to change Forcox 150 mg to AKURI T4 3 tablets together 2 hour later dinner .
would it be advisable from your End to shift the Medication from Forecox to Akuri T4 ( as there is little less pyrazinamide & Isoniazid than Forecox 150 mg)
Also pl suggest me if she can take the medicine with Milkh .
Dr. Raval is telling that he has written Zedocef o (Cefpodoxime -Ofloxacin) as USG neck is showing abscess in the Nodules , so to check if any other secondary infection is there
& the last as she has already completed 12 days of treatment in split doses - what are the chances of Resistance .
Should i Go for any Culture Examination to Check MDR -TB
Brief Answer:
Continue with forecox 3 tablets in the morning.
Detailed Answer:
Hello dear, thanks for your follow up question.
In my opinion you should continue with forecox only. As her weight is 60 kg, akurit 4 3 tablets will be under dosing for her. So continue with forecox 3 tablets together in morning.
And yes, she can take it with milk. No harm in it.
And start Proton pump Inhibitor and antiemetic combination to avoid gastritis and vomiting. Give this tablet on empty stomach before forecox.
And since she is responding to the treatment (size of swellings are decreased and subjective feeling of wellbeingness), no need for culture examination. And no need to worry for MDR TB too.
Start statins as her lipid profile is altered.
Start multivitamin tablet containing pyridoxine for speedy recovery.
Repeat ultrasound neck after 2 months of treatment to look for improvement in size of nodes and abscess present or not.
Hope I have solved your query. If you are not having further queries, please close the conversation and rate the answer... Thanks.
Continue with forecox 3 tablets in the morning.
Detailed Answer:
Hello dear, thanks for your follow up question.
In my opinion you should continue with forecox only. As her weight is 60 kg, akurit 4 3 tablets will be under dosing for her. So continue with forecox 3 tablets together in morning.
And yes, she can take it with milk. No harm in it.
And start Proton pump Inhibitor and antiemetic combination to avoid gastritis and vomiting. Give this tablet on empty stomach before forecox.
And since she is responding to the treatment (size of swellings are decreased and subjective feeling of wellbeingness), no need for culture examination. And no need to worry for MDR TB too.
Start statins as her lipid profile is altered.
Start multivitamin tablet containing pyridoxine for speedy recovery.
Repeat ultrasound neck after 2 months of treatment to look for improvement in size of nodes and abscess present or not.
Hope I have solved your query. If you are not having further queries, please close the conversation and rate the answer... Thanks.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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