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Tuberculosis is a deadly and infectious disease. If it is not treated in time, it could be fatal. Treated Tuberculosis is said to have a mortality rate of only 5 %, whereas if it is left untreated, 2 out of every 3 infected people will not survive. For everyone affected by this disease it is very important to follow the right form of treatment, and for that awareness is a must.
The standard treatment for Active TB is Isoniazid, Rifampicin, Pyrazinamine, and Ethambutol for a period of two months, and then continue with isoniazid and rifampicin for a further four months. At the end of this 6 month period, the patient is said to be cured, but a 2-3% chance of relapse is possible.
For Latent TB , the standard treatment is a prescription of isoniazid alone for a period of 6-9 months. The prescription is one tablet a day. Ethambutol is not to be used, if the organism concerned is fully sensitive. In this case treatment is carried on the same as that for Active TB but with the absence of Ethambutol.
It is very important for the patients to continue with their medication regularly. The TB bacterium is a very slow dieing one, and takes a minimum of 6 months for all the bacteria to die with the medicines. These medicines do not give you immediate relief and you will start to feel the difference only after a few weeks. One must continue with the medication, till all the bacteria are dead, even though you might feel better and the symptoms are disappearing, the bacteria are still alive.
The basic and most effective way of treating TB is through combination therapy, which means a combination of medication. There are various theories which prove this to be the best form of treatment. For example, Isoniazid and Ethambutol are bacteriostatic, which implies they stop the bacteria from growing, but do not kill them. Where as Rifampicin actually kills the bacteria.
Treatment for extrapulmonary TB:
For extra pulmonary TB, the UK and WHO recommend a prescription of isoniazid, rifampicin, ethambutol and pyrazinamide for two months, and isoniazid and rifampicin for a further four months. The US recommendation for the same is two months of isoniazid, rifampicin, ethambutol and pyrazinamide, and a continuation of isoniazid and rifampicin for another seven months.
It so happens that 25% of patients suffering from TB of the lymph nodes on treatment will first get worse, before they begin to feel better. A few weeks into the treatment, the lymph nodes enlarge and the previously solid lymph nodes become fluctuant. This should not be a subject to panic about, since it is quite normal. Two to three months into the treatment, the lymph nodes begin to shrink.
TB of the Central Nervous System:
The standard procedure for this form of TB is 12 months of treatment. This includes 2 months of isoniazid, rifampicin, ethambutol and pyrazinamide, and 10 months of isoniazid and rifampicin. Steroids are mandatory during this treatment.
The medications:
- Isoniazid: It is important for everyone to bear in mind not to consume alcohol while taking isoniazid. Some of the side effects of this drug include- rash, abnormal, hepatitis, sideroblastic anemia, peripheral neuropathy, headache, poor concentration, poor memory and depression. Trade-names Isokin, Isonex, Solonex.
- Rifampicin: Certain adverse effects known to be caused by this drug are-Fever, gastrointestinal disturbances, rashes and immunological reactions. Liver damage, associated with jaundice, has also been reported and in some rare cases has led to death. At times bodily fluids, such as urine and tears, are known to become orange-red in color. Trade-names Rcin, Rcinex.
- Pyrazinamide: The most common side affect of this drug (1%) is joint pains, and the most dangerous side effect is Hepatitis. Hepatitis is a dose related side effect, and since its dosage has been reduced, the occurrence of Hepatitis has greatly fallen. Other minor side effects include – nausea, vomiting, anorexia, skin rash, sideroblastic anemia, pruritus, dysuria, hyperuricemia, interstitial nephritis, malaise and fever. Trade names PZA.
- Ethambutol: Optic neuritis, red-green color blindness, peripheral neuropathy and arthralgia are some of the side effects caused by ethambutol. Trade names Combutol, Themibutol.
Drug treatment is available.
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