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During the follow up period, 4 patients from group-A and 1 patient from groupB could not be followed after the 5th month of treatment. One patient of groupB failed to afford the cost of the drug after the 3rd month and 1 patient of group-C died within a fortnight of admission.

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See your doctor. TB requires prescription medicine and diligent medical care. There is no homeopathic or over-the-counter treatment for TB.

In the United States there has been a call for the elimination of tuberculosis, and a committee constituted by the Institute of Medicine IOM issued a set of recommendations for reaching this goal 5. The IOM committee had two main recommendations related to treatment of tuberculosis; first, that all U.S jurisdictions have health regulations that mandate completion of therapy treatment until the patient is cured; and second, that all treatment be administered in the context of patient-centered programs that are based on individual patient characteristics and needs. The IOM recommendations emphasize the importance of the structure and organization of treatment services, as well as the drugs that are used, to treat patients effectively. This philosophy is the core of the DOTS strategy described in Section 10 Treatment of Tuberculosis in Low-Income Countries: Recommendations oof the WHO and the IUTLD, developed by the IUATLD and implemented globally by the WHO. Thus, although there are superficial differences in the approach to tuberculosis treatment between high- and low-incidence countries, the fundamental concern, regardless of where treatment is given, is ensuring patient adherence to the drug regimen and successful completion of therapy 6.

Monitoring. Monitoring is similar to that recommended for rifampin. Although drug interactions are less problematic with rifabutin, they still occur and close monitoring is required.

In a study reported by Ungo and associates 20, it was demonstrated that the relative risk of developing drug-induced hepatoxicity in tuberculosis patients with hepatitis C virus or HIV infection was 5- and 4-fold, respectively, compared with a 14-fold relative risk in patients with both hepatitis C virus and HIV infections. This finding was not confirmed in a study from Baltimore, in which rates of transaminase elevation were not greater in patients with HIV and hepatitis C virus who were given INH 21. Current IDSA and USPHS guidelines recommend screening all HIV-infected patients for hepatitis C virus 22. Until more data are available it is probably prudent to provide more frequent clinical and laboratory monitoring, as described for patients with preexisting liver disease, for patients with HIV infection or hepatitis C virus infection who are being treated for tuberculosis.

Ethionamide is contraindicated in patients with severe hepatic impairment and in patients who are hypersensitive to the drug.

Generic Trileptal is used for treating certain types of seizures in patients with epilepsy. It may be used alone or in combination with other medicines.

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