Why do you remove pyrazinamide after 2 months of intensive therapy tuberculosis?

Pyrazinamide is one of the first-line drugs used in the treatment of tuberculosis. It is typically used during the intensive phase of treatment, which usually lasts for 2 months. After this, pyrazinamide is discontinued while other drugs, such as rifampicin, isoniazid, and ethambutol, are continued for a further 4 to 7 months.

There are several reasons why pyrazinamide is discontinued after 2 months. One reason is that pyrazinamide can cause hepatotoxicity (liver damage) in some people especially in high dose. To minimise the risk of this, pyrazinamide is usually only given for a limited period of time.

Another reason for discontinuing pyrazinamide is that it is relatively more expensive compared to other drugs and can cause hyperuricemia (high levels of uric acid in the blood) which may lead to gouty arthritis. Other possible reasons include:

- Development of resistance to pyrazinamide

- Potential drug interactions with other medications

It's important to note that the exact duration of pyrazinamide therapy may vary depending on the specific treatment regimen being used and the individual's response to the medication. This is why it is crucial for patients to follow the treatment plan prescribed by their healthcare professional.