Drug Rechallenge in Adverse Cutaneous Drug Reactions to Antitubercular Therapy: A Case Series

Adverse Cutaneous Drug Reactions (CADRs) to Anti-Tubercular Therapy (ATT) range from mild pruritus to severe reactions such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), often leading to treatment interruption. Rechallenge is particularly challenging as reactions commonly occur during the intensive phase involving multiple drugs. In this case series of seven patients, structured inpatient rechallenge protocols enabled the identification of culprit drugs and the successful completion of ATT in all cases. Rifampicin was tolerated in all patients, while isoniazid and pyrazinamide were most frequently implicated. All patients were followed for 6-12 months without recurrence. This series highlights that supervised rechallenge, with careful monitoring, can optimise treatment completion while ensuring patient safety