Treatment of Tuberculosis

Treatment of Tuberculosis. In a hospital, people with pulmonary tuberculosis are kept in isolation in a room that is carefully designed to reduce the danger of infection spread through the air. The door is kept shut as much as possible, and the room’s air is changed at least 12 times every hour. If people in isolation can follow instructions on how to cover their coughs, they won’t need to wear a surgical face mask. People who enter the room, however, must wear a respirator (a specially fitted filter device, not a simple surgical mask).

When someone has obviously responded to treatment—typically, when all of the following occur—they can be moved from isolation to a general hospital room.

For a long time, their sputum samples were negative (no tuberculosis bacteria were found).

They haven’t had a fever in a long time.

Their hunger and sense of well-being have returned.

Treatment of Tuberculosis

Antibiotics

Tuberculosis can be treated with a variety of drugs. Antibiotics must be used for a long time—at least 6 months—due to the slow growth of tuberculosis bacteria. Treatment must be continued even if persons appear to be in good health. Because tuberculosis was not completely eradicated, it tends to reappear. In addition, TB germs may develop resistance to drugs.

Most people find it challenging to remember to take their medications on a daily basis for such an extended period of time. Others, for a variety of reasons, discontinue treatment as soon as they begin to feel better. Many doctors recommend that persons with tuberculosis get their medications from a health care worker who observes them take the pills because of these issues. Directly observed therapy is the name for this method (DOT). After the first two weeks, the medications are usually only administered 2 or 3 times each week to ensure that everyone gets all of their doses.

Because therapy with only one antibiotic can leave a few germs resistant to that medicine, two or more antibiotics that function in distinct ways are always provided. A few bacteria would not be enough to produce a relapse in most other microorganisms, but when tuberculosis is treated with only one antibiotic, the tuberculosis bacteria quickly grow resistant to that drug.

For persons who have never been treated previously, there are usually two rounds of treatment:

People are given four antibiotics for two months during the intensive period.
Continuation phase: Depending on the findings of sputum testing and chest x-rays, people take only two antibiotics for another 4 to 7 months.
Antibiotics are the most often used antibiotics.

• Isoniazid
• Rifampin
• Pyrazinamide
• Ethambutol

These four medicines are usually taken together and in that order (called first-line drugs). This treatment plan may include streptomycin. Although all of these medications have side effects, 95 percent of tuberculosis patients are cured with them and have no major side effects.

These medications come in a variety of combinations and dosage regimes. Isoniazid, rifampin, and pyrazinamide might all be combined in one capsule, reducing the number of medications individuals need to take each day and lowering the risk of drug resistance. Antibiotics needed to treat tuberculosis are frequently taken all at once, once a day, or twice or three times a week, unlike other antibiotics.

When the bacteria that causes tuberculosis has become resistant to first-line treatments or when people cannot tolerate the first-line drugs, second-line drugs are frequently utilized. Other antibiotics are used as backup treatments. Aminoglycosides (streptomycin, kanamycin, and amikacin, for example), capreomycin (which is related to aminoglycosides), and fluoroquinolones are among them (such as levofloxacin and moxifloxacin).

Other medications are occasionally used to treat tuberculosis, but they are less effective and have a greater number of negative effects. They’re usually only used to treat tuberculosis that has become resistant to conventional treatments.

Drug resistance

Antibiotic resistance can rapidly develop in tuberculosis bacteria, especially when people do not take the treatments on a regular basis or for as long as they should.

Bacteria that resist antibiotic therapy are causing an increase in tuberculosis cases (called drug-resistant tuberculosis). In 2016, an estimated 600,000 persons got rifampin-resistant TB (rifampicin). Isoniazid and other medicines were also resistant in about 490,000 of these cases.

Drug resistance is a major problem since drug-resistant TB requires long-term treatment. Typically, people need to take four or five medicines for 18 to 24 months. Drugs used to treat drug-resistant tuberculosis are frequently ineffective, poisonous, and costly.

Antibiotic-resistant tuberculosis microorganisms are called tuberculosis bacteria.

Multidrug-resistant tuberculosis (MDR-TB) is a kind of tuberculosis that is resistant to at least isoniazid and rifampin.

XDR-TB (extensively drug-resistant tuberculosis): Isoniazid, rifampin, fluoroquinolones, and at least one of three additional antibiotics administered by injection are all resistant.

Several novel tuberculosis medications, such as bedaquiline, delamanid, and sutezolid, are active against drug-resistant tuberculosis germs and could help curb the drug resistance epidemic.

Antibiotic-resistant tuberculosis microorganisms are called tuberculosis bacteria.

Multidrug-resistant tuberculosis (MDR-TB) is a kind of tuberculosis that is resistant to at least isoniazid and rifampin.

XDR-TB (extensively drug-resistant tuberculosis): Isoniazid, rifampin, fluoroquinolones, and at least one of three additional antibiotics administered by injection are all resistant.

Several novel tuberculosis medications, such as bedaquiline, delamanid, and sutezolid, are active against drug-resistant tuberculosis germs and could help curb the drug resistance epidemic.

Other options for treatment

When people stick to the drug treatment regimen, surgery to remove a piece of the lung is rarely required. However, surgery is sometimes required to treat the following conditions:

Infections that are extremely drug-resistant
Coughing up blood on a regular basis
Pus that has collected in the airways (to drain it)
When tuberculous pericarditis restricts the heart’s mobility significantly, the pericardium may need to be surgically removed. Surgery may be required to remove a tuberculoma in the brain.

When tuberculosis causes a large degree of inflammation, such as meningitis, pericarditis, or lung inflammation, doctors may prescribe corticosteroids (such as dexamethasone).

Read Tuberculosis Symptoms