Treatment Overview

Doctors treat tuberculosis (TB) with antibiotics to kill the TB bacteria. These medicines are given to everyone who has TB, including infants, children, pregnant women, and people who have a weakened immune system.

When treating active TB, health experts recommend:⁴

• Using more than one medicine to prevent multidrug-resistant TB. The standard treatment begins with four medicines given for 2 months.
• Continuing treatment for 4 to 9 months or longer if needed. The number of medicines used during this time depends on the results of sensitivity testing.
• Using directly observed therapy (DOT). This means visits with a health professional who watches you every time you take your medicine. A cure for TB requires you to take all doses of the antibiotics. These visits ensure that people follow medicine instructions, which is helpful because of the long treatment course for TB.
• Trying a different combination of medicines if the treatment is not working because of drug resistance (when tests show that TB-causing bacteria are still active).
• Using different treatment programs for people infected with the human immunodeficiency virus (HIV), people infected with TB bacteria that are resistant to one or more medicines, pregnant women, and children.

When treating latent TB, experts recommend one of the following:

• Using one medicine to kill the TB bacteria and prevent active TB. The standard treatment is isoniazid taken for 9 months. For people who cannot take isoniazid for 9 months, sometimes a 6-month treatment program is done.¹
• Taking two antibiotics once a week for 12 weeks to kill the TB bacteria.⁵ For this treatment, a health professional watches you take each dose of antibiotics. Taking every dose of antibiotic helps prevent the TB bacteria from getting resistant to the antibiotics.
• Treatment with rifampin for 4 months. This is an acceptable alternate treatment, especially for people who have been exposed to bacteria that is resistant to isoniazid.¹

Treatment is recommended for anyone with a skin test that shows a TB infection, and is especially important for people who:

• Are known to or are likely to be infected with the human immunodeficiency virus (HIV).
• Have close contact with a person who has active TB.
• Have a chest X-ray that suggests a TB infection and have not had a complete course of treatment.
• Inject illegal drugs.
• Have medical conditions or take medicines that weaken the immune system.
• Have had a tuberculin skin test within the past 2 years that did not show a TB infection but now a new test indicates an infection.

Treatment for extrapulmonary tuberculosis

Treatment for tuberculosis in parts of the body other than the lungs (extrapulmonary TB) usually is the same as for pulmonary TB. You may need other medicines or forms of treatment depending on where the infection is in the body and whether complications develop.

You may need treatment in a hospital if you have:

• Severe symptoms.
• TB that is resistant to multiple-drug therapy.

What to think about

If treatment is not successful, the TB infection can flare up again (relapse). People who have relapses usually have them within 6 to 12 months after treatment. Treatment for relapse is based on the severity of the disease and which medicines were used during the first treatment.