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Category Archives: TB


What’s the Treatment for Tuberculosis?

With the proper treatment, tuberculosis (TB, for short) is almost always curable.

Doctors prescribe antibiotics to kill the bacteria that cause it. You’ll need to take them for 6 to 9 months. What medications you take and how long you’ll have to take them depends on which works to eradicate your TB. Sometimes, antibiotics used to treat the disease don’t work. Doctors call this “drug-resistant” TB. If you have this form of the disease, you may need to take stronger medications for longer.

Treatment for Latent TB

There are two types of TB — latent and active.

Depending on your risk factors, latent TB can re-activate and cause an active infection. That’s why your doctor might prescribe medication to kill the inactive bacteria — just in case.

These are the three treatment options:

  • Isoniazid (INH): This is the most common therapy for latent TB. You typically take an isoniazid antibiotic pill daily for 9 months.
  • Rifampin (Rifadin, Rimactane): You take this antibiotic each day for 4 months. It’s an option if you have side effects or contraindications to INH.
  • Isoniazid and rifapentine: You take both of these antibiotics once a week for 3 months under your doctor’s supervision.

Treatment for Active TB

If you have this form of the disease, you’ll need to take a number of antibiotics for 6 to 9 months. These four medications are most commonly used to treat it:

  • Ethambutol (Myambutal)
  • Isoniazid
  • Pyrazinamide
  • Rifampin

Your doctor may order a test that shows which antibiotics will kill the TB strain. Based on the results, you’ll take three or four medications for 2 months. Afterward, you’ll take two medications for 4 to 7 months.

You’ll probably start to feel better after a few weeks of treatment. But only a doctor can tell you if you’re still contagious. If you’re not, you may be able to go back to your daily routine.

Treatment for Drug-Resistant TB

If you have a TB strain that doesn’t respond to the usual medications used to treat TB, you have a drug-resistent strain. This means that you will be treated with a combination of second-line drugs, which may be less effective. You will need to take these drugs for a longer period of time.

If several types of medications don’t do the job, you have what doctors call “multidrug-resistant TB.” You’ll need to take a combination of medications for 20 to 30 months. They include:

  • Antibiotics called fluoroquinolones
  • An injectable antibiotic, such as amikacin (Amikin), capreomycin (Capastat), and kanamycin
  • Newer antibiotic treatments, such as bedaquiline (Sirturo), ethionamide (Trecator), and para-amino salicylic acid. These are given in addition to other medications. The new drug Pretomanid is used in conjunction with bedaquiline and linezolid.Scientists are still studying these medicines.

A rare and serious type of the disease is called “extensively drug-resistant TB.” This means that many of the common medications — including isoniazid, rifampin, fluoroquinolones, and at least one of the antibiotics that are injected — don’t knock it out. Research shows that it can be cured around 30% to 50% of the time.

Side Effects of Treatment

Tell your doctor right away if you have any of the following symptoms:

  • Fever for 3 or more days
  • Pain in the lower abdomen
  • Itchiness or a rash
  • Nausea, vomiting, or no appetite
  • Yellowish skin or eyes
  • Dark or brown urine
  • Tingling, burning, or numbness of the hands and feet
  • Fatigue
  • Easy bruising or bleeding
  • Dizziness

It’s important to take every dose of your antibiotics. Don’t stop, even if you feel better. If you don’t kill all of the bacteria in your body, the remaining germs can adapt and become drug-resistant.

To help you remember, your doctor may need to watch you take your medication. This is called directly observed therapy. It’s recommended for treatment programs where you take antibiotics a few times a week instead of every day.

Preventing the Spread of TB

If you have active TB of the lungs, you can infect other people. For that reason, your doctor will tell you to stay home during the first few weeks of treatment, until you’re no longer contagious. During that time, you should avoid public places and people with weakened immune systems, like young children, the elderly, and people with HIV. You’ll have to wear a special mask if you have visitors or need to go to the doctor’s office.

Or your health care provider may admit you to the hospital until TB germs are no longer expelled in your cough. You may be hospitalized for a longer period if you cannot reliably take your medications, do not have stable housing, or have a multidrug resistant strain of TB. The goal is to prevent the spread of the disease.



Tuberculosis (TB)

What is Tuberculosis?

Tuberculosis — or TB, as it’s commonly called — is a contagious infection that usually attacks your lungs. It can spread to other parts of your body, like your brain and spine. A type of bacteria called Mycobacterium tuberculosis causes it.

In the early 20th century, TB was a leading cause of death in the United States. Today, most cases are cured with antibiotics. But it takes a long time. You have to take meds for at least 6 to 9 months.

In the 20th century, TB was a leading cause of death in the United States. Today, most cases are cured with antibiotics. But it takes a long time. You have to take meds for at least 6 to 9 months.

Tuberculosis Types

A TB infection doesn’t mean you’ll get sick. There are two forms of the disease:

Latent TB. You have the germs in your body, but your immune system stops them from spreading. That means you don’t have any symptoms and you’re not contagious. But the infection is still alive in your body and can one day become active. If you’re at high risk for re-activation — for instance, you have HIV, your primary infection was in the past 2 years, your chest X-ray is abnormal, or your immune system is compromised — your doctor will treat you with antibiotics to lower the risk for developing active TB.  

Active TB. This means the germs multiply and can make you sick. You can spread the disease to others. Ninety percent of adult cases of active TB are from the reactivation of a latent TB infection.

Tuberculosis Signs and Symptoms

There aren’t any for latent TB. You’ll need to get a skin or blood test to find out whether you have it.

There are usually signs if you have active TB disease. They include:

  • A cough that lasts more than 3 weeks
  • Chest pain
  • Coughing up blood
  • Feeling tired all the time
  • Night sweats
  • Chills
  • Fever
  • Loss of appetite
  • Weight loss

If you have any of these symptoms, see your doctor to get tested. Get medical help right away if you have chest pain.

Tuberculosis Causes and How TB Is Spread

Tuberculosis is caused by bacteria that spread through the air, just like a cold or the flu. When someone who has it coughs, sneezes, talks, laughs, or sings, tiny droplets that contain the germs are released. If you breathe in these germs, you can get it.

TB can spread from person to person, but it isn’t easy to catch. You usually have to spend a lot of time around someone who has a lot of bacilli in their lungs. You’re most likely to catch it from co-workers, friends, and family members.

Tuberculosis germs don’t thrive on surfaces. You can’t get the disease from shaking hands with someone who has it or by sharing their food or drink. 

Tuberculosis Diagnosis

There are two common tests for tuberculosis, but they don’t tell you whether you have latent or active TB:

  • Skin test. This is also known as the Mantoux tuberculin skin test. A health care worker injects a small amount of fluid into the skin of your lower arm. After 2 or 3 days, they’ll check for swelling in your arm to determine your results. If your results are positive, you probably have been infected with TB bacteria. But the results can be false positive. If you’ve gotten a tuberculosis vaccine called bacillus Calmette-Guerin (BCG), the test could say you have TB when you really don’t. The results can also be false negative, saying that you don’t have TB when you really do, if your infection is recent. You might get this test more than once.
  • Blood test. These tests, also called interferon-gamma release assays or IGRAs, measure the response when TB proteins are mixed with a small amount of your blood.

If you have a positive skin or blood test, your doctor will probably give you a chest X-ray or CT scan to look for changes in your lungs. They also might test for TB bacteria in your sputum, the mucus that comes up when you cough. These results will help diagnose latent or active TB.

Tuberculosis Treatment

Your treatment will depend on whether you have latent TB or active TB.

  • If you have latent TB, your doctor will probably give you medications to kill the bacteria so you don’t develop active TB. If you start to see any of the symptoms of active TB, call your doctor right away.
  • Your doctor will treat active TB with a combination of medications. You’ll take them for 6 to 12 months.

Whether you have latent or active TB, it’s important to finish taking all of your medications, even if you feel better after starting them.

Tuberculosis Risks

You can get TB only if you come into contact with others who have it. Other things that could increase your risk include:

  • A friend, co-worker, or family member has active TB.
  • You live in or have traveled to an area where TB is common, like Russia, Africa, Eastern Europe, Asia, Latin America, and the Caribbean.
  • You’re part of a group in which TB is more likely to spread, or you work or live with someone who is. This includes homeless people, people with HIV, people in jail or prison, and people who inject drugs into their veins.
  • You work or live in a hospital or nursing home.
  • You’re a health care worker for patients at high risk of TB.
  • You’re a smoker.Tuberculosis Complications

Tuberculosis Complications

A healthy immune system fights the TB bacteria. But if you have any of the following, you might not be able to fend off active TB disease:

  • HIV or AIDS
  • Diabetes
  • Severe kidney disease
  • Head and neck cancers
  • Cancer treatments such as chemotherapy
  • Low body weight and malnutrition
  • Medications for organ transplants
  • Certain drugs to treat rheumatoid arthritis, Crohn’s disease, and psoriasis

Babies and young children also are at greater risk because their immune systems aren’t fully formed.

Tuberculosis Prevention

To help stop the spread of TB:

  • If you have latent TB, take all of your medication so you don’t develop active TB, which is contagious.
  • If you have active TB, limit your contact with other people at work, school, or home. Cover your mouth when you laugh, sneeze, or cough. Wear a surgical mask when you’re around other people during the first weeks of treatment.
  • If you’re traveling to a place where TB is common, avoid getting close to or spending a lot of time in crowded places with people who have TB.

Children in countries where TB is common often get the BCG vaccine. It isn’t recommended in the United States. Other vaccines are being developed and tested.



Tuberculosis Prevention: What to Know

It may sound like a disease of the past, but tuberculosis, or TB, is still a real concern today. And as the old saying goes, an ounce of prevention is worth a pound of cure. In other words, the best way to be well is to avoid getting sick in the first place.

How Is TB Spread?

A person who has the active disease in their lungs can spread it through the air. “Active” means the TB germs are multiplying and spreading in your body. If you’re in close contact with someone who has it, you can get it. That’s why doctors advise those who have active TB disease to stay home and away from other people as much as possible, until they’re no longer infectious.

Stop the Spread of TB

If you have active TB disease, you must get treated right away. This might involve taking a number of medications for 6 to 12 months. It’s important to take all of your meds, as they’re prescribed, the entire time — even if you feel better. If not, you can get sick again.

If you have TB germs in your body but they haven’t become active, you have what doctors call “latent TB.” You can’t spread the disease to others. But your doctor may still recommend that you take medications to keep the germs from becoming active.

Follow these other tips to help prevent others from getting TB during your first few weeks of treatment, or until your doctor says you’re no longer contagious:

  • Take all of your medicines as they’re prescribed, until your doctor takes you off them.
  • Keep all your doctor appointments.
  • Always cover your mouth with a tissue when you cough or sneeze. Seal the tissue in a plastic bag, then throw it away.
  • Wash your hands after coughing or sneezing.
  • Don’t visit other people and don’t invite them to visit you.
  • Stay home from work, school, or other public places.
  • Use a fan or open windows to move around fresh air.
  • Don’t use public transportation.

In countries with high rates of TB infection, infants are often given the Bacillus Calmette-Guérin vaccine, or BCG. Doctors in the U.S. don’t generally recommend it because TB isn’t a widespread problem here.

Still, health care workers who spend a lot of time around TB patients might benefit from the vaccine. Doctors make that decision based on the health care worker and their unique circumstances.


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