Tuberculosis (TB) Facts (cont.)

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What is the treatment for tuberculosis?

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The treatment for TB depends on the type of TB infection and drug sensitivity of the mycobacteria. For latent TB, three anti-TB drugs are used in four different recommended schedules. The drugs are isoniazid (INH), rifampin (RIF; Rifadin), and rifapentine (RPT; Priftin) and the 2013 CDC's four recommended schedules are below and are chosen by the treating doctor based on the patients overall health and type of TB the patient was likely exposed to.


 
 
 

Latent TB Infection Treatment Regimens
Drugs Duration Interval Minimum Doses
Isoniazid 9 months Daily
Twice weekly
270
76
Isoniazid 6 months Daily
Twice weekly
180
52
Isoniazid and Rifapentine 3 months Once weekly 12
Rifampin 4 months Daily 120
Table reproduced from the CDC; http://www.cdc.gov/tb/topic/treatment/default.htm

First-line drugs used to treat active TB are INH, RIF, ethambutol (EMB; Myambutol), and pyrazinamide. The CDC offers a guide for the basic treatment schedules for active TB as follows:

Basic TB Disease Treatment Regimens
Preferred Regimen Alternative Regimen Alternative Regimen
Initial Phase
Daily INH, RIF, PZA, and EMB* for 56 doses (8 weeks)
Initial Phase
Daily INH, RIF, PZA, and EMB* for 14 doses (2 weeks), then twice weekly for 12 doses (6 weeks)
Initial Phase
Thrice-weekly INH, RIF, PZA, and EMB* for 24 doses (8 weeks)
Continuation Phase
Daily INH and RIF for 126 doses (18 weeks)
or
twice-weekly INH and RIF for 36 doses (18 weeks)
Continuation Phase
Twice-weekly INH and RIF for 36 doses (18 weeks)
Continuation Phase
Thrice-weekly INH and RIF for 54 doses (18 weeks)
*EMB can be discontinued if drug susceptibility studies demonstrate susceptibility to first-line drugs; Table reproduced from http://www.cdc.gov/tb/topic/treatment/tbdisease.htm#2

Treatment of drug-resistant TB can be difficult. Patients with these infections are recommended by the CDC to involve infectious-disease specialists as there are multiple approaches that involve other anti-TB drugs and variable treatment schedules that can be used. In addition, there are new drugs and treatment schedules being developed and approved by the FDA. The infectious-disease consultant may be aware of these newest treatments that may benefit specific patients. For example, bedaquiline (Sirturo) has been approved for treatment of MDR TB.

In some patients, the lung destruction may be severe and the only treatment left may be surgical resection of the diseased lung tissue.

Medically Reviewed by a Doctor on 1/24/2014

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