Tuberculosis: 9. Treatment

Table 2: Doses of and common adverse reactions* to second-line antituberculosis drugs*   Daily dose inadults and children           Drug Usual Maximal Recommended   regular monitoring  Adverse reactions† Cycloserine  150–250       mg 500 mg Mental status Neurologic and psychiatric disturbance, convulsions, rash Ethionamide 15–20 mg/kg 750 mg Hepatic enzymes Gastrointestinal disturbance, hepatotoxicity, hypersensitivity Capreomycin 15–30 mg/kg 1 g Vestibular function, audiometry, blood urea nitrogen, creatinine Auditory, vestibular and renal toxic effects Kanamycin, amikacin 15–30 mg/kg 1 g Vestibular function, audiometry, blood urea nitrogen, creatinine, hepatic enzymes Auditory and renal toxic effects; rarely, vestibular toxic effects Fluoroquinolones         Ciprofloxacin 500–750 mg twice daily 1 g   Gastrointestinal upset Ofloxacin 600–800 mg 1 g   Gastrointestinal upset Levofloxacin 500 mg 750 mg   Gastrointestinal upset Sparfloxacin 200 mg     Gastrointestinal upset Note: Second-line drugs are more difficult to use than first-line drugs. They should be used only when necessary and should be given and monitored by health care providers experienced in their use. *Adapted from the Tuberculosis Committee of the Canadian Thoracic Society,17 and the American Thoracic Society.18 †All of these drugs may cause rash, nausea and fever.

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