What is the treatment and monitoring plan for tuberculosis (TB) disease?
For each patient with newly diagnosed TB disease, a specific treatment and monitoring plan should be developed in collaboration with the TB control program within 1 week of the presumptive diagnosis. This plan should include: Description of the TB treatment regimen;
How can we optimize tuberculosis treatment?
Recommendations for Optimizing Tuberculosis Treatment: Therapeutic Drug Monitoring, Pharmacogenetics, and Nutritional Status Considerations Although tuberculosis is largely a curable disease, it remains a major cause of morbidity and mortality worldwide.
Is the standard treatment regimen effective for drug-susceptible tuberculosis?
Although the standard 6-month treatment regimen is highly effective for drug-susceptible tuberculosis, the use of multiple drugs over long periods of time can cause frequent adverse dru … Although tuberculosis is largely a curable disease, it remains a major cause of morbidity and mortality worldwide.
What is video observed therapy for tuberculosis?
A recent innovation to help patients adhere to daily tuberculosis (TB) treatment over many months is video (or virtually) observed therapy (VOT). VOT is becoming increasingly feasible as mobile telephone applications and tablet computers become more widely available.
What is the treatment regimen for tuberculosis?
The preferred regimen for treating adults with TB remains a regimen consisting of an intensive phase of 2 months of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB) followed by a continuation phase of 4 months of INH and RIF.
Which test will give information about which antibiotics will be effective against TB?
Test for TB Infection The Mantoux tuberculin skin test is performed by injecting a small amount of fluid called tuberculin into the skin in the lower part of the arm. The test is read within 48 to 72 hours by a trained health care worker, who looks for a reaction (induration) on the arm.
What monitoring is necessary while taking rifampin and isoniazid?
Pharmacodynamic Interactions Isoniazid, when given concomitantly with rifampin, has been reported to increase the hepatotoxicity of both drugs. Patients receiving both rifampin and isoniazid as in RIFAMATE should be monitored closely for hepatotoxicity.
What should I monitor with isoniazid?
Carefully monitor patients who are daily users of alcohol, those who are >35 years of age, those receiving long-term concomitant therapy, those who previously discontinued isoniazid, those who use illicit injection drugs, those with a history of peripheral neuropathy or conditions predisposing to neuropathy, those with ...
What is the most accurate test for tuberculosis?
The most commonly used diagnostic tool for tuberculosis is a skin test, though blood tests are becoming more commonplace. A small amount of a substance called tuberculin is injected just below the skin on the inside of your forearm. You should feel only a slight needle prick.
What is the Kirby Bauer method in susceptibility testing?
The Kirby-Bauer disk diffusion susceptibility test determines the sensitivity or resistance of pathogenic bacteria to various antimicrobial compounds in order to assist physicians in selecting treatment options their patients.
How do you monitor TB?
New pulmonary TB patients with positive sputum smears at the start of treatment. These patients should be monitored by sputum smear microscopy at the end of the fifth and sixth months. If results at the fifth or sixth month are positive, a sputum specimen should be obtained for culture and DST.
How can we prevent the side effects of TB medicine?
Main Adverse ReactionsCan be due to TB drugs causing stomach irritation.Take drugs embedded in banana.Avoid smoking and drinking alcohol.Eat nutritious food.Inform and consult your doctor / nurse.
How does isoniazid and rifampin work?
Rifampin and isoniazid combination is used to treat tuberculosis (TB) infection. It may be taken alone or with one or more other medicines for TB. Rifampin belongs to the class of medicines called antibiotics and works to kill or prevent the growth of bacteria.
What is MX test?
The Mantoux test or Mendel–Mantoux test (also known as the Mantoux screening test, tuberculin sensitivity test, Pirquet test, or PPD test for purified protein derivative) is a tool for screening for tuberculosis (TB) and for tuberculosis diagnosis.
Who isoniazid preventive therapy guidelines?
The usual preventive therapy regimen is isoniazid (10 mg/kg daily for children, up to a maximum adult dose of 300 mg daily). The recommended duration of isoniazid preventive treatment varies from 6 to 12 months of continuous therapy (9).
What tests are done to check for TB?
Lab tests are performed during tuberculosis treatment to determine if any TB bacteria are left in your body. Sputum tests, which examine the thick mucous that is characteristic of TB, are typically done on people undergoing tuberculosis treatment for active pulmonary (lung) tuberculosis disease.
How do you know if TB treatment is working?
Physical Signs That TB Treatment Is Working. Physical signs of tuberculosis treatment success include: A reduction in symptoms, such as less coughing. Overall improvement in the way one feels. Weight gain.
What happens if you don't treat tuberculosis?
If tuberculosis treatment isn't successful or isn't followed for the full course, complications may occur. These could include: 1 Permanent damage to the lungs 2 Spread to other organs and organ damage 3 Development of strains of TB bacteria that are resistant to typical drugs 4 Death
What happens if TB is not treated?
These could include: Permanent damage to the lungs. Spread to other organs and organ damage. Development of strains of TB bacteria that are resistant to typical drugs. Death.
Can antibiotics cause TB?
Side effects from the strong antibiotics prescribed to treat TB are also very common and need to be closely monitored, too. "Side effects from the medications vary depending on the drug used, but with most drugs, liver inflammation is the most common side effect," Smulian says.
Can you get TB with antibiotics?
When you have a simple bacterial infection, a prescription for an antibiotic is usually all you need. But tuberculosis is no simple bacterial infection, and the many months of tuberculosis treatment require careful monitoring. Your doctor will keep a close eye on your TB once you start receiving treatment to make sure that ...
Monitoring Therapy Adherence of Tuberculosis Patients by using Video-Enabled Electronic Devices
Alistair Story, Richard S. Garfein, Andrew Hayward, Valiantsin Rusovich, Andrei Dadu, Viorel Soltan, Alexandru Oprunenco, Kelly Collins, Rohit Sarin, Subhi Quraishi, Mukta Sharma, Giovanni Battista Migliori, Maithili Varadarajan, and Dennis Falzon
Abstract
A recent innovation to help patients adhere to daily tuberculosis (TB) treatment over many months is video (or virtually) observed therapy (VOT). VOT is becoming increasingly feasible as mobile telephone applications and tablet computers become more widely available.
Acknowledgment
R.S.G. was supported by a National Institutes of Health grant (U01 AI116392) for the writing of this paper; no other dedicated financial support was otherwise provided for the other authors. A.D., D.F., V.R., M.S., and M. V. were all staff members of WHO at the time of writing of this paper.
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.
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).
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.
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 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
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).
How long does it take to develop a TB control plan?
For each patient with newly diagnosed TB disease, a specific treatment and monitoring plan should be developed in collaboration with the local TB control program within 1 week of the presumptive diagnosis. This plan should include: