Multiple-Drug Therapy for Tuberculosis (TB)
How It Works
These antibiotics kill the bacteria that cause
Multiple-drug therapy to treat TB means taking several different antibiotics at the same time. This is the first choice of treatment for TB that is growing in your body (active TB disease). Most of these medicines are given as pills. The American Thoracic Society, Centers for Disease Control and Prevention, and the Infectious Diseases Society of America recommend using one of several combinations of the first-choice medicines to start treatment.
The standard treatment is to take isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months. Treatment is then continued for at least 4 months with fewer medicines. Also, there are special treatment recommendations for
Prepared combination medicines, such as Rifater, are usually used when there is a need for fewer numbers of pills, such as when a health professional is not giving each dose of medicine personally. Combining antibiotics into a single pill makes it less likely that you will miss taking any doses. Failure to take a medicine could prolong your treatment and increase your chance of developing
Streptomycin usually is given only to people who cannot take ethambutol.
Some antibiotics (such as isoniazid or rifampin) may be taken alone to prevent a
Why It Is Used
Treatment with several medicines makes it more likely that all TB-causing bacteria will be killed. The combination of medicines and the length of treatment may change based on:
How Well It Works
Treatment for active TB disease
The standard treatment for TB using a combination of four medicines is very effective. Almost everyone infected with TB bacteria that can be killed by the medicines are cured if they take the medicines exactly as they should.
It takes at least 6 months of treatment for a cure. It could take longer if doses are missed. It can also take longer if the disease does not respond well to the medicine.
Treatment for latent TB infection
Treatment with isoniazid alone for 6 to 12 months will prevent active TB disease in most people who have a
Also, taking a combination of two antibiotics for 3 months is an effective way to treat latent TB.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call your doctor right away if you are taking isoniazid, rifampin, or pyrazinamide and you develop:
Call your doctor right away if you are taking ethambutol and you develop:
Call your doctor right away if you are taking levofloxacin or moxifloxacin and you develop:
Rifampin colors your urine, sputum, sweat, and tears orange-red. This is normal. The color will go away when you stop taking the medicine. But it will stain your clothing and your contact lenses.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
It is important to take all of the medicines during your treatment to ensure the infection is cured, to protect others from TB, and to reduce the risk of a relapse.
It is best to take these medicines without food. But if they upset your stomach, you can take them with food.
Do not drink alcohol during treatment for TB, because it can increase your risk of liver damage.
Before and sometimes during treatment with these medicines, you may have tests to check your liver.
If you have active TB, the health department will test people who work or live with you to see if they have a TB infection. If they have TB, they will get treated to prevent the spread of the disease.
A health professional may have to watch you take all doses of your medicines. This is called
If you must be in the hospital during TB treatment, you will be in a special room that filters the TB bacteria out of the air. This will prevent health care workers and other people in the hospital from getting a TB infection. You probably will not be able to leave the room until you have 3 sputum samples that show you can no longer spread the infection.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
A woman can breast-feed her baby during TB treatment without worrying that the medicines will harm the baby.
Streptomycin, rifapentine, and capreomycin
Do not use this medicine if you are pregnant or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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