Tuberculosis, or TB, is a disease that primarily affects the lungs and is spread through the cough, sneeze or saliva of an infected person. The disease is highly contagious and although eradicated, it has made a comeback due to antibiotic resistance, poverty and HIV infection, according to The Merck Manuals Online Medical Library. TB bacteria have infected about one-third of the population around the world, and about 5 to 10 percent of people infected get sick, according to the World Health Organization. Several treatment options for TB are available, depending on the stage of the disease.
Active TB
According to the Mayo Clinic, active TB refers to full-blown TB infection and requires taking four different types of drugs. They include pyrazinamide, rifampin, ethambutol and isoniazid. The combination of drugs allows for aggressive treatment of the disease, which may take between six and nine months to clear up. Throughout this time, the patient is monitored and the drug combination may change, depending on effectiveness.
Newer drugs are available that ensure easier dosage delivery. Rifater is a combination of rifampin, pyrazinamide and isoniazid in one tablet form, while rifapentine may be taken once a week with other drugs to lessen the number of treatment days.
Latent TB
Latent TB refers to the presence of the TB bacteria in the body that are dormant. They do not produce disease immediately but may in the future when the immune system becomes suppressed due to age or illness. Treatments are usually directed at preventing active TB disease. Isoniazid is the primary treatment and is taken daily or twice a week for nine months, according to the Mayo Clinic. Liver testing is usually required to monitor side effects of the drug, which may affect the liver. Alcohol and acetaminophen use should be limited or avoided to prevent liver damage, notes the Mayo Clinic.
Drug Resistant TB
Drug resistant TB falls into two categories. Multi-drug resistance refers to the TB bacteria being resistant to rifampin and isoniazid, which are first-line drugs. Extensive drug resistance refers to the bacteria that are resistant to first- and second-line drugs, according to the Mayo Clinic. Treatment usually involves four drug combinations of both first- and second-line drugs that are known to work. These drugs may be taken for 18 months to two years, according to the World Health Organization. This method does not always work and if it does, surgery is required to repair any damage to organs like the lungs.
Treating Pregnant Women and Children
Pregnant women are usually treated with ethambutol, isoniazid and rifampin but not pyrazinamide, due to safety issues with the unborn fetus. Children are treated the same as adults with the exception of ethambutol, which may cause vision problems, according to the Mayo Clinic. Streptomycin is used instead to fight the infection.
Side Effects
According to the Canadian Lung Association, side effects of taking these medications include nausea and vomiting, fever, muscle pain, chills, blurred vision, dark urine, jaundice, sore abdomen and a loss of appetite.
