A 25-year-old female has been diagnosed to be suffering from tuberculosis categorized as Category II (Sputum+ve relapse). The treatment regimen recommended under DOTS is –
**Core Concept**
Tuberculosis (TB) treatment under the Directly Observed Treatment, Short-Course (DOTS) strategy involves categorizing patients into different categories based on their disease severity, previous treatment history, and drug resistance patterns. Category II TB refers to a patient with a sputum-positive relapse, indicating a history of previous TB treatment that failed.
**Why the Correct Answer is Right**
For Category II TB, the recommended treatment regimen under DOTS involves a combination of four first-line anti-TB drugs: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), and Ethambutol (E). This regimen is designed to effectively treat the relapse while minimizing the risk of drug resistance. The addition of Ethambutol helps to prevent the emergence of resistance to Isoniazid and Rifampicin.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not include the recommended combination of four first-line anti-TB drugs required for Category II TB treatment.
**Option B:** This option is incorrect as it lacks the essential component of Pyrazinamide (Z), which is crucial for treating the relapse in Category II TB.
**Option C:** This option is incorrect as it includes Streptomycin, which is not a standard component of the recommended treatment regimen for Category II TB under DOTS.
**Clinical Pearl / High-Yield Fact**
When treating TB under DOTS, it's essential to follow the recommended treatment regimens for each category to ensure effective treatment and prevent the emergence of drug resistance.
**Correct Answer:** C. HRZE (Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol)