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How we treat pulmonary tuberculosis in patient with raised att induced serum creatinine around 7?

patient was diagnosed as a case of pulmonary TB, ATT was started but he build up serum creatinine around7. Streptomycin and ethambutol was stopped but still he has raised creatinine level. how we further manage this patient regarding his antituberculous therapy.?

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Question added by Pawan Kumar Nagdev , Fellow General Medicine , Civil Hospital Karachi
Date Posted: 2015/03/26
Nauman Wazir
by Nauman Wazir , Assistant Professor and Consultant Endocrinology , Lady Reading Hospital

Streptomycin induced nephrotoxicity can be permanent.  Adding a floroquinolono to the first line regimen instead of ethambutol is the option as the other first line ATT are not excreated via kidney

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