CASE SCENARIO:

A 40 year old male came to opd with complaints of chronic cough with
expectoration , hemoptysis , evening rise of fever , weight loss for 2
months . his sputum examination showed acid fast bacilli and chest x-ray
showed cavitations. What is the probable diagnosis and treatment ?
 NEW RNTCP REGIMEN AND
TRETMENT FOR ATYPICAL
MYCOBACTERIAL INFECTION

BY RAMPRASATH.J
 SLO

 At the end of the session the students should be able to classify the newer drug regimen of RNTCP
 At the end of the session the students should be able to summarize the treatment for atypical
mycobacteria
RNTCP REGIMEN
The treatment for TB have two phases:
• INTENSIVE PHASE: The patient receives intensive treatment with four to
six drugs daily for a period of two months. The main objective is to kill the
bacilli and render the patient non contagious.
• CONTINUATION PHASE: The patient receive three to four drugs daily for
a period of 4 months. This phase helps to eliminate remaining bacilli and
prevents relapse .
MYCOBACTERIAL AVIUM COMPLEX
INFECTION
• It is a opportunistic pathogen which causes disseminated and multifocal
disease in immunocompromised HIV patients.
• This disease develops when cell mediated immunity is markedly
depressed (CD4 <50 cells/µl)
THERAPY FOR MAC INFECTION
• Therapy is directed to suppress the disease and afford symptomatic relief
until immune status of the patient improves by ART .
• A favored regimen consist of 3 or 4 drug intensive phase followed by 2 drug
maintained phase.
• The duration of intensive phase dependent on the response till CD4 count
rises, which my take 2-6 months
• The maintenance phase is continued till a minimum of 12 months.
• All patients must receive ART therapy for HIV infection simultaneously.
SUMMARY
• RNTCP regimen has two phases- intensive and continuation phase.
• Regimen includes first line drugs – ISONIAZID,RIFAMPIN,
PYRIZINAMIDE,ETHAMBUTOL ,STREPTOMYCIN.
• Regimen for mycobacterium avium complex infection includes
clarithromycin, azithromycin, ethambutol, rifabutin.