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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.
Directly observed treatment, short-course (DOTS, also known as TB-DOTS) is the name given to the tuberculosis (TB) control strategy recommended by the World Health Organization. [1] According to WHO, "The most cost-effective way to stop the spread of TB in communities with a high incidence is by curing it.
Ethionamide is an antibiotic used to treat tuberculosis. [2] Specifically it is used, along with other antituberculosis medications, to treat active multidrug-resistant tuberculosis. [2] It is no longer recommended for leprosy. [3] [2] It is taken by mouth. [2] Ethionamide has a high rate of side effects. [4]
Isoniazid, also known as isonicotinic acid hydrazide (INH), is an antibiotic used for the treatment of tuberculosis. [4] For active tuberculosis, it is often used together with rifampicin, pyrazinamide, and either streptomycin or ethambutol. [5] For latent tuberculosis, it is often used alone. [4]
The old dose for pyrazinamide was 40–70 mg/kg daily and the incidence of drug-induced hepatitis has fallen significantly since the recommended dose has been reduced to 12–30 mg/kg daily. In the standard four-drug regimen (isoniazid, rifampicin, pyrazinamide, ethambutol), pyrazinamide is the most common cause of drug-induced hepatitis. [13]
Ethambutol/isoniazid is a fixed-dose combination medication used to treat tuberculosis. [1] It is a fixed dose combination of ethambutol and isoniazid. [1] It is used along with other antituberculosis medication. [1] It is taken by mouth. [1] Side effects are those of the underlying medications. [1]
Extensively drug-resistant TB is also resistant to three or more of the six classes of second-line drugs. [155] Totally drug-resistant TB is resistant to all currently used drugs. [ 156 ] It was first observed in 2003 in Italy, [ 157 ] but not widely reported until 2012, [ 156 ] [ 158 ] and has also been found in Iran and India. [ 159 ]
Mycobacterial resistance to rifampicin may occur alone or along with resistance to other first-line antitubercular drugs. Early detection of such multidrug or extensively drug-resistant tuberculosis is critical in improving patient outcomes by instituting appropriate second-line treatments, and in decreasing transmission of drug-resistant TB. [54]