Tuberculosis - Treatment

In the past, treatment of tuberculosis was primarily supportive. Patients were kept in isolation, away from the healthy population. They were encouraged to rest and to eat well. If these measures failed, surgery was used. Today, surgical procedures are used much less often. Instead, drug therapy has become the primary means of treatment. Patients with TB can now safely rest at home; they pose no threat to other members of the household.

Drug Therapy

Drugs provide the most effective treatment for TB patients. Three principles govern the use of drug treatment for tuberculosis:

• First, the number of bacilli must be lowered as quickly as possible. By so doing, the risk of transmitting the disease to other people is reduced.
• Second, efforts must be made to prevent the development of drug resistance. If a person develops a resistance to a drug, it will no longer be helpful in curing the disease. As a result, most patients are given a combination of two or three different drugs at first.
• Third, drug treatment must be continued to prevent reoccurrence of the disease.

Five drugs are used today to treat tuberculosis. They are isoniazid (also known as INH; pronounced eye-suh-NY-uh-zid, trade names Laniazid, Nydrazid); rifampin (pronounced ry-FAM-puhn, trade names Rifadin, Rimactane); pyrazinamide (pronounced pir-uh-ZIN-uh-mide, trade name Tebrazid); streptomycin (pronounced strep-tuh-MYS-uhn); and ethambutol (pronounced eth-AM-byoo-tol, trade name Myambutol). The first three drugs are often combined into a single capsule so that patients have fewer pills to take.

Surgery

Surgery is sometimes used to treat tuberculosis when medication is not effective. One form of surgery involves the introduction of air into the chest. This procedure causes the lung to collapse. In a second procedure, one or more ribs may be removed. A third procedure involves the removal of all or part of a diseased lung. Other forms of surgery may be used in cases of extrapulmonary tuberculosis.