American Board of Internal Medicine (ABIM) Certification Practice Exam

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How long is the initiation phase of tuberculosis therapy with the recommended first-line agents?

2 weeks
8 weeks
4 months
6 months

The correct answer is: 8 weeks

The initiation phase of tuberculosis (TB) therapy typically lasts for 2 months, during which a combination of first-line antitubercular agents is utilized to effectively target the Mycobacterium tuberculosis bacteria. This phase is crucial for rapidly reducing the bacterial load, preventing transmission, and minimizing the risk of developing drug resistance. The standard regimen during the initiation phase includes the use of four first-line agents: isoniazid, rifampin, pyrazinamide, and ethambutol. Administering these medications together for the first 2 months ensures that the treatment is aggressive enough to address the bacteria's potential resistance mechanisms and helps in transitioning to the continuation phase, where the regimen is usually simplified. The other durations mentioned are not consistent with the established treatment guidelines. The 8 weeks in this context accurately reflects the initiation phase and emphasizes the importance of adhering to this timeframe to optimize therapeutic outcomes.