* Streptomycin during pregnancy can cause permanent deafness in the baby.
* Do not give streptomycin in pregnancy. Use ethambutol instead.
* Isoniazid, rifampicin, pyrazinamide and ethambutol are safe to use.
* Second-line drugs such as fluoroquinolones, ethionamide and protionamide are teratogenic, and should not be used.
* All anti-TB drugs are compatible with breastfeeding.
* Ethionamide and protionamide are also safe.
* The excretion of streptomycin is renal. The excretion of ethambutol and thioacetazone is partly renal.
* Avoid streptomycin and ethambutol if there are alternatives. Otherwise give in reduced doses at less frequent intervals.
* Do not give thioacetazone. The margin between the therapeutic and toxic dose is too narrow.
* The safest regimen to give to patients in renal failure is 2HRZ/4HR.
* Most anti-TB drugs can cause liver damage and therefore care is needed.
* Do not give pyrazinamide because this is the most hepatotoxic anti-TB drug.
* Isoniazid and rifampicin plus one or two non-hepatotoxic drugs, such as streptomycin and ethambutol, can be used for a total treatment duration of eight months.
* If the patient has severe liver damage, an alternative regimen is streptomycin plus isoniazid plus ethambutol in the initial phase followed by isoniazid and ethambutol in the continuation phase with a total duration of 12 months.
* Recommended regimens are 2SRHE/6HE or 2SHE/I0HE.
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