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Medical Author:

George Schiffman, MD, FCCP

George Schiffman, MD, FCCP

Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Today, doctors treat most people with TB outside the hospital. Gone are the days of going to the mountains for long periods of bed rest. Doctors seldom use surgery.

• Doctors will prescribe several special medications that you must take for six to nine months.
• Standard therapy for active TB consists of a six-month regimen:
• two months with Rifater (isoniazid, rifampin, and pyrazinamide);
• four months of isoniazid and rifampin (Rifamate, Rimactane);
• and ethambutol (Myambutol) or streptomycin added until your drug sensitivity is known (from the results of bacterial cultures).
• Treatment takes that long because the disease organisms grow very slowly and, unfortunately, also die very slowly. (Mycobacterium tuberculosis is a very slow-growing organism and may take up to six weeks to grow in a culture media.)
• Doctors use multiple drugs to reduce the likelihood of resistant organisms emerging.
• Often the drugs will be changed or chosen based on the laboratory results.
• If doctors doubt that you are taking your medicine, they may have you come to the office for doses. Prescribing doses twice a week helps assure compliance.
• The most common cause of treatment failure is people's failure to comply with the medical regimen. This may lead to the emergence of drug-resistant organisms. You must take your medications as directed, even if you are feeling better.

• Doctors likely will contact or trace your relatives and friends.
• Your relatives and friends may need to undergo appropriate skin tests and chest X-rays.

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