A patient has been diagnosed as a case of pulmonary tuberculosis and started on antituberculosis therapy. A month later he reported to you with jaundice. On stopping treatment jaundice has recovered. Now antituberculosis therapy has to be restarted which of the following drugs is least likely to be cause of his jaundice:
A. Rifampicin
B. Streptomycin
C. INH
D. Ethambutol
E. Pyrazinamide
Answer:
B. Streptomycin [REF]
Explanation:
Streptomycin, an aminoglycoside antibiotic with bactericidal properties, is regarded as a safe choice for individuals with preexisting liver conditions. Similarly, Capreomycin, just like Streptomycin, undergoes elimination through the kidneys without significant liver metabolism. These drugs are considered suitable for individuals with underlying liver diseases and can be used as second-line options if patients experience hepatotoxic effects when treated with first-line antituberculosis medication
Here’s an explanation for each option:
A. Rifampicin: Rifampicin is a well-known hepatotoxic drug used in tuberculosis therapy. It can lead to elevated liver enzymes and jaundice. It’s a common cause of drug-induced hepatitis in these patients.
C. Isoniazid (INH): INH can also cause liver enzyme elevation and hepatitis, but it’s generally less likely to do so compared to rifampicin.
D. Ethambutol: Ethambutol is associated with a lower likelihood of causing liver toxicity and jaundice compared to rifampicin.
E. Pyrazinamide: Pyrazinamide can also lead to hepatotoxicity, but it’s not as common as with rifampicin.