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Pulmonary tuberculosis - Treatment

Alternative Names

TB; Tuberculosis - pulmonary

Treatment:

The goal of treatment is to cure the infection with drugs that fight the TB bacteria. Treatment of active pulmonary TB will always involve a combination of many drugs (usually four drugs). All of the drugs are continued until lab tests show which medicines work best.

The most commonly used drugs include:

  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol

Other drugs that may be used to treat TB include:

  • Amikacin
  • Ethionamide
  • Moxifloxacin
  • Para-aminosalicylic acid
  • Streptomycin

You may need to take many different pills at different times of the day for 6 months or longer. It is very important that you take the pills the way your health care provider instructed.

When people do not take their TB medications as recommended, the infection becomes much more difficult to treat. The TB bacteria may become resistant to treatment, and sometimes, the drugs no longer help treat the infection.

When there is a concern that a patient may not take all the medication as directed, a health care provider may need to watch the person take the prescribed drugs. This is called directly observed therapy. In this case, drugs may be given 2 or 3 times per week, as prescribed by a doctor.

You may need to be admitted to a hospital for 2 - 4 weeks to avoid spreading the disease to others until you are no longer contagious.

Your doctor or nurse is required by law to report your TB illness to the local health department. Your health care team will be sure that you receive the best care for your TB.

Support Groups:

You can ease the stress of illness by joining a support group where members share common experiences and problems.

See: Lung disease - support group

Expectations (prognosis):

Symptoms often improve in 2 - 3 weeks. A chest x-ray will not show this improvement until later. The outlook is excellent if pulmonary TB is diagnosed early and treatment is begun quickly.

Complications:

Pulmonary TB can cause permanent lung damage if not treated early.

Medicines used to treat TB may cause side effects, including liver problems. Other side effects include:

  • Changes in vision
  • Orange- or brown-colored tears and urine
  • Rash

A vision test may be done before treatment so your doctor can monitor any changes in your eyes' health over time.

Calling your health care provider:

Call your health care provider if:

  • You have been exposed to TB
  • You develop symptoms of TB
  • Your symptoms continue despite treatment
  • New symptoms develop
  • Reviewed last on: 12/7/2010
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Iseman MD. Tuberculosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 345.

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolan R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Orlando, FL: Saunders Elsevier; 2009:chap 250.

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