The anti-tuberculosis therapy is a unique, two-phased chemotherapy consisting of initial intensive phase with multiple drugs (three or more) and continuation phase with two or three drugs.
What is the current treatment for TB?
5 rows · The 6- to 9-month RIPE TB treatment regimens consist of. R ifampin (RIF), I soniazid (INH), P ...
What drug is used to treat TB?
Regimens for treating TB have an initial phase of 2 months, followed by a continuation phase of either 4 or 7 months. This is because even though most tubercle bacilli are killed within the first 8 weeks of treatment (initial phase), there are still active bacilli in the body.
What is the treatment for the infectious stage of TB?
For treatment of new cases of pulmonary or extrapulmonary TB, WHO recommends a standardized regimen consisting of two phases. The initial (intensive) phase uses four drugs (rifampicin, isoniazid, pyrazinamide and ethambutol) administered for two months.
What drugs treat TB?
The standard of care for initiating treatment of TB disease is four-drug therapy. Treatment with a single drug can lead to the . development of a bacterial population resistant to that drug. Study Questions. 6.1 The major goals for treatment of TB disease include which of the following? A. Curing the individual patient. B.
What are the phases of standard treatment of TB?
How many phases does TB have?
How many treatments are there for tuberculosis?
What are the 4 stages of TB?
Why is TB treated with 4 drugs?
Which among the following is used in the treatment of tuberculosis?
What are the 3 types of tuberculosis?
- Active TB Disease. Active TB is an illness in which the TB bacteria are rapidly multiplying and invading different organs of the body. ...
- Miliary TB. Miliary TB is a rare form of active disease that occurs when TB bacteria find their way into the bloodstream. ...
- Latent TB Infection.
How long is TB treatment?
What is TB prevention?
What is the latent stage of TB?
What are the 5 causes of TB?
- Poverty.
- HIV infection.
- Homelessness.
- Being in jail or prison (where close contact can spread infection)
- Substance abuse.
- Taking medication that weakens the immune system.
- Kidney disease and diabetes.
- Organ transplants.
How is latent TB treated?
What is the best treatment for TB?
The medications used to treat latent TB infection include the following: Isoniazid (INH) Rifapentine (RPT) Rifampin (RIF) These medications are used on their own or in combination, as shown in the table below.
What is the name of the drug that is used to treat TB?
Isoniazid (INH) Rifapentine (RPT) Rifampin (RIF) These medications are used on their own or in combination, as shown in the table below. CDC and the National Tuberculosis Controllers Association (NTCA) preferentially recommend short-course, rifamycin-based, 3- or 4-month latent TB infection treatment regimens over 6- or 9-month isoniazid ...
Is TB regimens applicable?
Although basic TB regimens are broadly applicable, there are modifications that should be made under special circumstances (i.e., HIV infection, drug resistance, pregnancy, or treatment of children). Listed below are the basic regimens; please refer to Treatment of Tuberculosis. external icon. 1 for all options for the treatment ...
How many drugs are there for TB?
There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: isoniazid (INH), rifampin (RIF), ethambutol (EMB), and. pyrazinamide (PZA).
Is TB a public health function?
Treating tuberculosis (TB) disease benefits not only the individual patient but the community as a whole.Thus, any health care provider undertaking treatment of a patient with TB, whether a public health or private practitioner, is assuming a public health function that includes the responsibility for not only prescribing an appropriate regimen but also ensuring the patient’s adherence to the regimen until treatment is completed.
How many anti-TB drugs are there?
There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are:
What is the first line of anti-TB drugs?
Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: isoniazid (INH), rifampin (RIF), ethambutol (EMB), and. pyrazinamide (PZA). Regimens for treating TB disease have an intensive phase of 2 months, followed by a continuation phase of either 4 or 7 months. The continuation phase should be extended ...
How is treatment completion determined?
Treatment completion is determined by the number of doses ingested over a given period of time. Although basic TB regimens are broadly applicable, there are modifications that should be made under special circumstances (i.e., HIV infection, drug resistance, pregnancy, or treatment of children).
What is a DOT in TB?
DOT is a strategy in which a health care worker or another designated person watches the TB patient swallow each dose of the anti-TB drugs. All patients taking drugs fewer than 7 days per week (e.g., 1, 2, 3, or 5 days a week) must receive DOT.
How long is the TB continuation phase?
The continuation phase of treatment is given for either 4 or 7 months. The 4-month continuation phase should be used in patients with uncomplicated, noncavitary, drug-susceptible TB, if there is documented sputum conversion within the first 2 months. The 7-month continuation phase is recommended only for
How long does it take to treat TB?
As a general rule, the principles used for the treatment of pulmonary TB disease also apply to extrapulmonary forms of the disease. A 6-month treatment regimen is recommended for patients with extrapulmonary TB disease, unless the organisms are known or strongly suspected to be resistant to the first-line drugs. If PZA cannot be used in the initial phase, the continuation phase must be increased to 7 months. The exception to these recommendations is central nervous system TB, for which the optimal length of therapy has not been established but some experts recommend 9 to 12 months. Most experts do recommend corticosteroids to be used as additional therapy for patients with TB meningitis and pericarditis. Consultation with a TB expert is recommended.
How to educate patients about TB?
Educating patients about TB disease helps ensure their successful completion of therapy. Health-care providers must take the time to explain clearly to patients what medication should be taken, how much, how often, and when. Patients should be clearly informed about possible adverse reactions to the medications they are taking and when to seek necessary medical attention. Providing patients with the knowledge they need regarding the consequences of not taking their medicine correctly is very important. In addition, patients should be educated about infection control measures and potential need for isolation (Table 6.1). HIV testing and counseling is recommended for all patients with TB disease in all health-care settings. The patient must first be notified that testing will be performed. The patient has the right to decline HIV testing and counseling (opt-out screening).
What is a dot in TB?
DOT is a component of case management that helps ensure patients adhere to therapy. It is the method whereby a trained health-care worker or another trained designated person watches a patient swallow each dose of anti-TB drugs and documents it. DOT is the preferred core management strategy recommended by CDC for treatment of TB disease and, if resources allow, for latent tuberculosis infection (LTBI) treatment. DOT can reduce the development of drug resistance, treatment failure, or relapse after the end of treatment. Good case management, which includes establishing a relationship with the patient and addressing barriers to adherence, facilitates successful DOT.
What are the drugs that treat TB?
Food and Drug Administration (FDA) for the treatment of TB disease (Table 6.2). In addition, the fluoroquinolones (levofloxacin, moxifloxacin, and gatifloxacin), although not approved by the FDA for TB disease, are commonly used to treat TB disease caused by drug-resistant organisms or for patients who are intolerant of some first-line drugs. Rifabutin, approved for use in preventing Mycobacterium avium complex disease in patients with HIV infection but not approved for TB disease, is useful for treating TB disease in patients concurrently taking drugs that interact with rifampin (e.g., certain antiretroviral drugs). Amikacin and kanamycin, nearly identical aminoglycoside drugs used in treating patients with TB disease caused by drug-resistant organisms, are not approved by the FDA for treatment of TB.
What is the recommended treatment regimen based on?
The recommended treatment regimens are based, in large part, on evidence from clinical trials and are rated on the basis of a system developed by the U.S. Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) (Table 6.3).
What are the four drugs that are included in the initial treatment regimen?
Four drugs— INH, RIF, PZA, and EMB — should be included in the initial treatment regimen until the results of drug-susceptibility tests are available. Each of the drugs in the initial regimen plays an important role. INH and RIF allow for short-course regimens with high cure rates. PZA has potent sterilizing activity, which allows further shortening of the regimen from 9 to 6 months. EMB helps to prevent the emergence of RIF resistance when primary INH resistance is present. If drug-susceptibility test results are known and the organisms are fully susceptible, EMB need not be included. For children whose clarity or sharpness of vision cannot be monitored, EMB is usually not recommended except when the risk of drug resistance is high or for children who have “adult-type” (upper lobe infiltration, cavity formation) TB disease.
How to cure MDR TB?
To cure MDR TB, healthcare providers must turn to a combination of second-line drugs, several of which are shown here. Second-line drugs may have more side effects, the treatment may last much longer, and the cost may be up to 100 times more than first-line therapy. MDR TB strains can also grow resistant to second-line drugs, ...
What is the new drug for TB?
Bedaquiline and Delamanid are new drugs. Ethambutol, Pyrazinamide, Thioamides, Cycloserine, Para-aminosalicylic acid, Streptomycin, and Clofazimine are possibly effective. Kanamycin, Capreomycin and Amikacin are injectable second-line. XDR TB occurs when a Mycobacterium tuberculosis strain is resistant to isoniazid and rifampin, ...
Is second line TB treatment more expensive than first line?
Second-line drugs may have more side effects, the treatment may last much longer, and the cost may be up to 100 times more than first-line therapy. MDR TB strains can also grow resistant to second-line drugs, further complicating treatment. Credit.
What is XDR TB?
XDR TB occurs when a Mycobacterium tuberculosis strain is resistant to isoniazid and rifampin, two of the most powerful first-line drugs, as well as key drugs of the second line regimen—any fluoroquinolone and at least one of the three injectable drugs shown above.
Who took the photo of Mycobacterium tuberculosis?
The photo of Mycobacterium tuberculosis is from the Centers for Disease Control and Prevention, CDC/Dr. Ray Butler, Janice Carr. This illustration is in the public domain. Please credit the National Institute of Allergy and Infectious Diseases (NIAID).
Is XDR TB resistant to isoniazid?
NIAID. XDR TB occurs when a Mycobacterium tuberculosis strain is resistant to isoniazid and rifampin, two of the most powerful first-line drugs, as well as key drugs of the second line regimen—any fluoroquinolone and at least one of the three injectable drugs shown above. XDR TB strains may also be resistant to additional drugs, ...
Introduction
Recommended Regimens
- There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: 1. isoniazid (INH), 2. rifampin (RIF), 3. ethambutol (EMB), and 4. pyrazinamide (PZA). Regimens for treating TB disease have an intensive phase of 2 ...
Hiv-Negative Persons
- A continuation phase of once-weekly INH and rifapentine can be used for HIV-negative patients who do not have cavities on the chest film and who have negative acid-fast bacilli (AFB) smears at the completion of the intensive phase of treatment.
Case Management
- Patient-centered case management should be used in the treatment strategy with an adherence plan that includes directly observed therapy (DOT). DOT is a strategy in which a health care worker or another designated person watches the TB patient swallow each dose of the anti-TB drugs. All patients taking drugs fewer than 7 days per week (e.g., 1, 2, 3, or 5 days a week) mustreceive DOT.
Follow-Up Evaluations
- Sputum specimens for microscopic examination and culture should be obtained from patients diagnosed with TB disease at a minimum of monthly intervals until two consecutive specimens are negative on culture. It is critical to obtain a sputum specimen at the end of the intensive phase (2 months) to determine if the continuation phase should be extended. In addition, it is essential …
For More Information
- Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin I...
- Special Considerations for Treatment of TB Disease in Persons Infected with HIV (Fact Sheet). Available online at https://www.cdc.gov/tb/publications/factsheets/treatment.htm