With the proper treatment, tuberculosis (TB, for short) is almost always curable.
Doctors prescribe antibiotics to kill the bacteria that cause it. You’ll need to take them for 6 to 9 months. What medications you take and how long you’ll have to take them depends on which works to eradicate your TB. Sometimes, antibiotics used to treat the disease don’t work. Doctors call this “drug-resistant" TB. If you have this form of the disease, you may need to take stronger medications for longer.
Treatment for Latent TB
There are two types of TB — latent and active.
Depending on your risk factors, latent TB can re-activate and cause an active infection. That’s why your doctor might prescribe medication to kill the inactive bacteria — just in case.
These are the three treatment options:
- Isoniazid (INH): This is the most common therapy for latent TB. You typically take an isoniazid antibiotic pill daily for 9 months.
- Rifampin (Rifadin, Rimactane): You take this antibiotic each day for 4 months. It’s an option if you have side effects or contraindications to INH.
- Isoniazid and rifapentine: You take both of these antibiotics once a week for 3 months under your doctor’s supervision.
Treatment for Active TB
If you have this form of the disease, you’ll need to take a number of antibiotics for 6 to 9 months. These four medications are most commonly used to treat it:
- Ethambutol (Myambutal)
Your doctor may order a test that shows which antibiotics will kill the TB strain. Based on the results, you’ll take three or four medications for 2 months. Afterward, you’ll take two medications for 4 to 7 months.
You’ll probably start to feel better after a few weeks of treatment. But only a doctor can tell you if you’re still contagious. If you’re not, you may be able to go back to your daily routine.
Treatment for Drug-Resistant TB
If you have a TB strain that doesn’t respond to the usual medications used to treat TB, you have a drug-resistent strain. This means that you will be treated with a combination of second-line drugs, which may be less effective. You will need to take these drugs for a longer period of time.
If several types of medications don’t do the job, you have what doctors call “multidrug-resistant TB.” You’ll need to take a combination of medications for 20 to 30 months. They include:
- Antibiotics called fluoroquinolones
- An injectable antibiotic, such as amikacin (Amikin), capreomycin (Capastat), and kanamycin
- Newer antibiotic treatments, such as bedaquiline (Sirturo), ethionamide (Trecator), and para-amino salicylic acid. These are given in addition to other medications. The new drug Pretomanid is used in conjunction with bedaquiline and linezolid.Scientists are still studying these medicines.
A rare and serious type of the disease is called “extensively drug-resistant TB." This means that many of the common medications — including isoniazid, rifampin, fluoroquinolones, and at least one of the antibiotics that are injected — don’t knock it out. Research shows that it can be cured around 30% to 50% of the time.
Side Effects of Treatment
Tell your doctor right away if you have any of the following symptoms:
- Fever for 3 or more days
- Pain in the lower abdomen
- Itchiness or a rash
- Nausea, vomiting, or no appetite
- Yellowish skin or eyes
- Dark or brown urine
- Tingling, burning, or numbness of the hands and feet
- Easy bruising or bleeding
It’s important to take every dose of your antibiotics. Don’t stop, even if you feel better. If you don’t kill all of the bacteria in your body, the remaining germs can adapt and become drug-resistant.
To help you remember, your doctor may need to watch you take your medication. This is called directly observed therapy. It’s recommended for treatment programs where you take antibiotics a few times a week instead of every day.
Preventing the Spread of TB
If you have active TB of the lungs, you can infect other people. For that reason, your doctor will tell you to stay home during the first few weeks of treatment, until you’re no longer contagious. During that time, you should avoid public places and people with weakened immune systems, like young children, the elderly, and people with HIV. You’ll have to wear a special mask if you have visitors or need to go to the doctor’s office.
Or your health care provider may admit you to the hospital until TB germs are no longer expelled in your cough. You may be hospitalized for a longer period if you cannot reliably take your medications, do not have stable housing, or have a multidrug resistant strain of TB. The goal is to prevent the spread of the disease.