CHAPTER 13 Antimicrobials—Fighting Infection^243
daily and take sulfonamides on an empty stomach. Patients should avoid the use
of antacids while taking sulfonamides because antacids decrease the absorption
of sulfonamides.
Tuberculosis
Tuberculosis is caused by acid-fast bacillus Mycobacterium tuberculosis. It is a
major health problem and kills more than any other infectious disease. One and
one-half billion people have TB. There are 8 million new cases each year. The
incidence had decreased in the United States but increased again in the 1980s.
This has been attributed in part to the numbers of persons with AIDS which
compromises the immune system.
First-line drugs used to treat tuberculosis are
- Isoniazid (INH, Nydrazid, Laniazid) PO/IM: 5–10 mg/kg/d in a single
dose; max: 300 mg/d; Prophylaxis: 300 mg/d
° Pregnancy Category: C; PB: 10%; t
(^1) ⁄ 2 : 104 h
° Side effects: drowsiness, tremors, rash, blurred vision, photosensitivity;
° Adverse reactions: psychotic behavior, peripheral neuropathy, vitamin
B 6 deficiency
° Life threatening: blood dyscrasias, thrombocytopenia, seizures, agranu-
locytosis, hepatotoxicity
Antitubular Drugs
Phase Example 1 Example 2 Example 3 Example 4
First phase Isoniazid, Isoniazid, Isoniazid, Isoniazid,
(2 mo) rifampin rifampin, rifampin, rifampin,
Pyrazinamide streptomycin phrazinamide,
kanamycin or
ciprofloxacin
Second phase Isoniazid, Isoniazid, Isoniazid, Isoniazid,
(4–7 mo) rifampin rifampin, rifampin, rifampin,
ethambutol capreomycin ethambutol,
or cycloserine streptomycin
or kanamycin
or ciprofloxacin
or clarithromycin
or capreomycin