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Management of tuberculosis refers to techniques and procedures utilized for treating tuberculosis (TB), or simply a treatment plan for TB. The medical standard for active TB is a short course treatment involving a combination of isoniazid , rifampicin (also known as Rifampin), pyrazinamide , and ethambutol for the first two months.
Styblo refined "a treatment system of checks and balances that provided high cure rates at a cost affordable for most developing countries." This increased the proportion of people cured of TB from 40% to nearly 80%, costing up to $10 per life saved and $3 per new infection avoided. [3]
The goal of tuberculosis elimination is hampered by the lack of rapid testing, short and effective treatment courses, and completely effective vaccine. [2] The WHO as well as the Stop TB Partnership aim for the full elimination of TB by 2050—requiring a 1000-fold reduction in tuberculosis incidence. [3]
Effective TB treatment is difficult, due to the unusual structure and chemical composition of the mycobacterial cell wall, which hinders the entry of drugs and makes many antibiotics ineffective. [137] Active TB is best treated with combinations of several antibiotics to reduce the risk of the bacteria developing antibiotic resistance. [14]
Treatment of MDR-TB requires treatment with second-line drugs, usually four or more anti-TB drugs for a minimum of 6 months, and possibly extending for 18–24 months if rifampin resistance has been identified in the specific strain of TB with which the patient has been infected. [9] Under ideal program conditions, MDR-TB cure rates can ...
Isoniazid can be used alone or in combination with Rifampin for treatment of latent tuberculosis, or as part of a four-drug regimen for treatment of active tuberculosis. [27] The drug regimen typically requires daily or weekly oral administration for a period of three to nine months, often under Directly Observed Therapy (DOT) supervision.
If these drugs are misused or mismanaged, multidrug-resistant TB (MDR-TB) can develop. MDR-TB takes longer to treat with second-line drugs (i.e., amikacin, kanamycin, or capreomycin), which are more expensive and have more side-effects. XDR-TB can develop when these second-line drugs are also misused or mismanaged and become ineffective.
The bottom line is that to get an effective treatment, it’s super important to make sure that the drugs being used will work against the specific strain of TB, that multiple medications are used together to prevent drug resistance from developing, and that medications are used for the entire course of therapy so that all of the mycobacterium ...