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Conduct drug susceptibility testing to inform the choice of treatment regimen
Addition of streptomycin to HRZE is no longer recommended
One of the basic principles of TB treatment is that a single drug should not be added to an unsuccessful regimen
Adding streptomycin to the previously unsuccessful HRZE regimen violates this principle and fuels resistance, leading to the loss of streptomycin as a second-line agent in MDR-TB therapy
On the basis of the drug susceptibility profile, a standard first-line treatment regimen (2HRZE/4HR) can be repeated if no resistance is documented
If rifampicin resistance is present, an MDR-TB regimen should be prescribed according to drug-resistant TB treatment guidelines
