Tuberculosis (TB): Active TB Disease


Immediate treatment with antibiotics is necessary to treat active TB disease. Since the advent of anti-TB medications in the 1940s, treatment of drug-susceptible TB (TB that is not drug-resistant) has become highly effective if administered and taken properly. Treatment no longer requires prolonged hospital stays. In most cases, a person with a new case of active TB can be treated at home. Others will enter the hospital in special rooms that minimize the chance of spreading the infection to other patients and staff, where they take medications until the disease is no longer infectious. When the patient is no longer infectious, he can leave the hospital and continue taking medication at home. Hospitalization may be a few weeks to several months depending on the severity of the disease and whether or not the patient has a safe place to live.

Since active TB is slow to respond completely to therapy, prescribed medications must be taken every day for a long time. This may be at least six months and, sometimes, a year or more. In most cases, a treatment program for drug-susceptible TB involves taking two to four medications. Your doctor may use the results of a sputum test to determine which antibiotics are most likely to be effective.

Some medications commonly used for active TB disease:

  • Isoniazid (INH)
  • Rifampin (Rifadin, or Rimactane)
  • Pyrazinamide
  • Ethambutol (Myambutol)
  • Streptomycin

Some of these drugs can cause liver damage, so your doctor will monitor your liver with blood tests during the course of your treatment. You should avoid acetaminophen (Tylenol) and alcohol while having TB treatment, as these can also cause liver damage. Also, women should be aware that rifampin makes hormonal birth control methods (such as the pill, implants, and the patch) less effective. Ethambutol can affect eyesight, including visual acuity and color vision, and some patients on this drug will need regular eye tests.

If you are having trouble taking your medications for any reason—forgetfulness, uncomfortable side effects such as nausea, or anything else—talk to your doctor. He or she may be able to help.

You may be asked to take your antibiotics under the observation of your doctor or other health care professional. This method of administration is called directly observed therapy (DOT) is the preferred way to treat TB disease. Many health departments will arrange for a health care worker to meet you daily at home or at work for this purpose. This is because forgetting to take your medication, or failure to take your medication as prescribed, can lead to the life-threatening condition of multidrug-resistant TB (MDR TB). Treating MDR-TB requires long hospital stays and high doses of antibiotic medications that often have severe side effects.

 

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