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Skin rash

  • If a patient develops minor itching and there is no other obvious cause (e.g. scabies), the recommended approach is to try symptomatic treatment with antihistamines, reassure the patient and advise to avoid dry skin, continue TB treatment and close observe.

  • However, if a symptomatic (i.e. severe itching and/or painful) skin rash develops, all anti-TB drugs must be stopped.

  • Once the reaction has resolved, anti-TB drugs may be reintroduced. Reintroducing TB treatment can be challenging when the particular TB drug responsible for the reaction is not known.

  • First introduce the drug that is least likely to cause the rash.

  • Generally the order of reintroduction is R, H, Z. You should wait for several days to assess the patient’s reaction before re- introducing the next drug.
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