What is the history of tuberculosis (TB) treatment?
In 1952, isoniazid opened the modern era of treatment; it was inexpensive, well tolerated, and safe. In the early 1960s, ethambutol was shown to be effective and better tolerated than para-aminosalicylic acid, which it replaced. In the 1970s, rifampin found its place as a keystone in the therapy of tuberculosis.
What is the history of rifampin therapy for tuberculosis (TB)?
In the 1970s, rifampin found its place as a keystone in the therapy of tuberculosis. The use of rifampin enabled the course of treatment to be reduced to nine months. Incorporation of pyrazinamide into the first-line regimen led to a further reduction of treatment duration to six months.
How long does it take to cure drug resistant tuberculosis?
TB Regimens for Drug-Susceptible TB. Regimens for treating TB disease have an intensive phase of 2 months, followed by a continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment).
What are the treatment regimens for tuberculosis (TB)?
Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: Regimens for treating TB disease have an intensive phase of 2 months, followed by a continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment).
How was TB treated in the 20th century?
In the late 19th and early 20th centuries sanatoria developed for the treatment of patients with tuberculosis. The rest provided there was supplemented with pulmonary collapse procedures designed to rest infected parts of lungs and to close cavities.
What year did they find a cure for tuberculosis?
The first successful remedy against TB was the introduction of the sanatorium cure, described for the first time in 1854 in the doctoral dissertation "Tuberculosis is a curable disease" by Hermann Brehmer, a botany student suffering himself from TB, who reported his healing after a travel to the Himalayan Mountains [44 ...
What is the treatment plan for tuberculosis?
The usual treatment is: 2 antibiotics (isoniazid and rifampicin) for 6 months. 2 additional antibiotics (pyrazinamide and ethambutol) for the first 2 months of the 6-month treatment period.
How was TB treated in the 1960s?
In the early 1960s, ethambutol was shown to be effective and better tolerated than para-aminosalicylic acid, which it replaced. In the 1970s, rifampin found its place as a keystone in the therapy of tuberculosis. The use of rifampin enabled the course of treatment to be reduced to nine months.
What was the treatment for TB before antibiotics?
Cod liver oil, vinegar massages, and inhaling hemlock or turpentine were all treatments for TB in the early 1800s. Antibiotics were a major breakthrough in TB treatment. In 1943, Selman Waksman, Elizabeth Bugie, and Albert Schatz developed streptomycin.
Is there a vaccine for tuberculosis?
The BCG vaccine protects against tuberculosis, which is also known as TB. TB is a serious infection that affects the lungs and sometimes other parts of the body, such as the brain (meningitis), bones, joints and kidneys.
What are the long term effects of tuberculosis?
If TB of the lung is not treated early or if treatment isn't followed, long-lasting (permanent) lung damage can result. TB can also cause infection of the bones, spine, brain and spinal cord, lymph glands, and other parts of the body.
What is the first-line drug for TB?
First-line agents for treatment of active TB consist of isoniazid, a rifamycin (rifampin or [less frequently] either rifapentine or rifabutin), pyrazinamide, and ethambutol; in addition, moxifloxacin is a first-line agent when administered in combination with isoniazid, rifapentine, and pyrazinamide [6].
Who wrote the article on the treatment of tuberculosis?
The following article titled “Treatment of Tuberculosis: A Historical Perspective” by John F. Murray, M.D., Dean E. Schraufnagel, M.D., and Philip C. Hopewell, M.D. , is the second in the series published in the Annals of the American Thoracic Society.
What was the first step in finding a cure for tuberculosis?
The first step in finding a cure was the discovery of the cause of tuberculosis by Robert Koch in 1882.
How long does pyrazinamide treatment last?
Incorporation of pyrazinamide into the first-line regimen led to a further reduction of treatment duration to six months. Treatment of multiple drug–resistant tuberculosis remains a difficult problem requiring lengthy treatment with toxic drugs.
How long did the discovery of streptomycin last?
The discovery of streptomycin brought about a great flurry of drug discovery research that lasted from the 1940s through the 1960s. As the decline in tuberculosis case rates became steeper, the awareness of the public waned. The war on tuberculosis was considered winnable with the tools at hand ( 43 ). Public health departments relegated tuberculosis care to general clinics and the fervor for new drug discovery fell.
How long has triple therapy been used for tuberculosis?
All together, “triple therapy” remained the standard treatment for all forms of tuberculosis for nearly 15 years ( 21 ). Despite these successes, side effects, drug resistance, and the large numbers of affected people drove further drug development exploration.
When was the ATS established?
New Drugs The Future References CITING ARTICLES. The American Thoracic Society (ATS) has a long history, originating as the American Sanatorium Association in 1905, which was established to promote the treatment and prevention of tuberculosis.
When did sanatoriums become superfluous?
With the advent of effective chemotherapy in the mid-1950s, sanatoriums began to become superfluous. By the mid-1960s most were closed. Hospital care was no longer required to provide effective treatment; moreover, patients receiving effective drug treatment quickly became noninfectious. A study in Madras, in which patients with tuberculosis were randomly assigned to either sanatorium or home treatment, showed no difference in either clinical outcomes or infection in the household contacts ( 12 ). S anatoriums had become obsolete.
What are the major landmarks of tuberculosis treatment?
The major historical landmarks of tuberculosis (TB) therapy include: the discovery of effective medications (streptomycin and para-aminosalicylic acid) in 1944; the revelation of "triple therapy" (streptomycin, para-aminosalicylic acid and isoniazid) in 1952, which assured cure; recognition in the 1970s that isoniazid and rifampin could reduce the duration of treatment from 18 to 9 months; and the observation in the 1980s that adding pyrazinamide to these drugs allowed cures in only 6 months. To combat noncompliance, intermittent regimens, twice or thrice weekly, have been proven to cure even far-advanced TB in as few as 62-78 encounters over 26 weeks. However, these regimens are not sufficiently short or convenient to facilitate effective treatment in resource-poor countries. Therefore, drug-resistant strains have emerged to threaten TB control in various areas of the world, including India, China, Russia and the former Soviet Union. For these reasons, it is vital that new medications are developed to shorten the duration of therapy, increase the dosing interval of intermittent regimens and replace agents lost to resistance. Other special considerations include identifying optimal therapy for persons with acquired immune deficiency syndrome, particularly noting the problems of drug/drug interactions for those receiving antiretroviral treatment. Finally, the Alchemist's Dream of tuberculosis should be pursued: modulating the immune response to shorten treatment and/or overcome drug resistance.
What are the major historical landmarks of tuberculosis?
Tuberculosis therapy: past, present and future. The major historical landmarks of tuberculosis (TB) therapy include: the discovery of effective medications (streptomycin and para-aminosalicylic acid) in 1944; the revelation of " triple therapy" (streptomycin, para-aminosalicylic acid and isoniazid) in 1952, which assured cure; recognition in the 1 ….
How long does it take to treat TB?
TB disease can be treated by taking several drugs for 6 to 9 months. 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)
What is drug resistant TB?
Drug-resistant TB is caused by TB bacteria that are resistant to at least one first-line anti-TB drug. Multidrug-resistant TB (MDR TB) is resistant to more than one anti-TB drug and at least isoniazid (INH) and rifampin (RIF).
What is XDR TB?
Extensively drug-resistant TB (XDR TB) is a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin). Treating and curing drug-resistant TB is complicated.
How is treatment completion determined?
Treatment completion is determined by the number of doses ingested over a given period of time.
How long does pyrazinamide last?
pyrazinamide (PZA) TB Regimens for Drug-Susceptible TB. Regimens for treating TB disease have an intensive phase of 2 months, followed by a continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment). Drug Susceptible TB Disease Treatment Regimens. Regimens for treating TB disease have an intensive phase of 2 months, ...
What is it called when TB bacteria multiply?
When TB bacteria become active (multiplying in the body) and the immune system can’t stop the bacteria from growing, this is called TB disease. TB disease will make a person sick. People with TB disease may spread the bacteria to people with whom they spend many hours.
Can TB be treated?
It is very important that people who have TB disease are treated, finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs.
Where was TB first found?
The first written documents describing TB, dating back to 3300 and 2300 years ago, were found in India and in China respectively [12, 13]. Other written documents connected to TB are related to the Hebraism.
Who was the first person to mention TB?
In Roman times, TB is mentioned by Celso, Aretaeus of Cappadocia and Caelius Aurelianus, but it is not recognized as sharing the same etiology of extrapulmonary manifestations such as scrofula, Pott's disease and TB lupus.
How long has Mycobacterium ulcerans been around?
It has been hypothesized that the genus Mycobacteriumoriginated more than 150 million years ago. Mycobacterium ulcerans, causing infections since ancient times, requires specific environmental conditions as reflected nowadays in its distribution worldwide [6].
What is TB called in ancient Greece?
In the Ancient Greece TB was well known and called Phtisis. Hippocrates described Phtisis as a fatal disease especially for young adults, accurately defining its symptoms and the characteristic tubercular lung lesions.
How many people are infected with TB?
MT has very ancient origins: it has survived over 70,000 years and it currently infects nearly 2 billion people worldwide [2]; with around 10.4 million new cases of TB each year, almost one third of the world's population are carriers of the TB bacillus and are at risk for developing active disease [3].
How many deaths from TB in 18th century?
In the 18thcentury in Western Europe, TB had become epidemic with a mortality rate as high as 900 deaths per 100,000 inhabitants per year, more elevated among young people. For this reason, TB was also called "the robber of youth".
What was the disease in the Middle Ages called?
In the Middle Ages, scrofula, a disease affecting cervical lymph nodes, was described as a new clinical form of TB. The illness was known in England and France as "king's evil", and it was widely believed that persons affected could heal after a royal touch.
How long do you have to take antibiotics for tuberculosis?
For active tuberculosis, you must take antibiotics for at least six to nine months. The exact drugs and length of treatment depend on your age, overall health, possible drug resistance and where the infection is in your body.
What test is used to 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 ...
How long does ethambutol last?
If you have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable medications, such as amikacin or capreomycin (Capastat), are generally used for 20 to 30 months. Some types of TB are developing resistance to these medications as well.
What is the test for TB?
Sputum tests. If your chest X-ray shows signs of tuberculosis, your doctor might take samples of your sputum — the mucus that comes up when you cough. The samples are tested for TB bacteria. Sputum samples can also be used to test for drug-resistant strains of TB.
What test can confirm active tuberculosis?
Blood tests can confirm or rule out latent or active tuberculosis. These tests measure your immune system's reaction to TB bacteria.
Can a TB test be wrong?
Results can be wrong. The TB skin test isn't perfect. Sometimes, it suggests that people have TB when they don't. It can also indicate that people don't have TB when they do. You can have a false-positive result if you've been vaccinated recently with the bacille Calmette-Guerin (BCG) vaccine.
Can TB drugs cause liver damage?
Serious side effects of TB drugs aren't common but can be dangerous when they do occur. All tuberculosis medications can be toxic to your liver. When taking these medications, call your doctor immediately if you have any of the following:
Who was the first person to recognize tuberculosis?
Franciscus Sylvius began differentiating between the various forms of tuberculosis (pulmonary, ganglion). He was the first person to recognize that the skin ulcers caused by scrofula resembled tubercles seen in phthisis, noting that "phthisis is the scrofula of the lung" in his book Opera Medica, published posthumously in 1679. Around the same time, Thomas Willis concluded that all diseases of the chest must ultimately lead to consumption. Willis did not know the exact cause of the disease but he blamed it on sugar or an acidity of the blood. Richard Morton published Phthisiologia, seu exercitationes de Phthisi tribus libris comprehensae in 1689, in which he emphasized the tubercle as the true cause of the disease. So common was the disease at the time that Morton is quoted as saying "I cannot sufficiently admire that anyone, at least after he comes to the flower of his youth, can [sic] dye without a touch of consumption."
How old is tuberculosis?
In 2014, results of a new DNA study of a tuberculosis genome reconstructed from remains in southern Peru suggest that human tuberculosis is less than 6,000 years old.
What is the most recent common ancestor of the Mycobacterium tuberculosis complex?
Origins. Scientific work investigating the evolutionary origins of the Mycobacterium tuberculosis complex has concluded that the most recent common ancestor of the complex was a human-specific pathogen, which underwent a population bottleneck.
How did the royal touch work?
Initially, the touching ceremony was an informal process. Sickly individuals could petition the court for a royal touch and the touch would be performed at the King's earliest convenience. At times, the King of France would touch afflicted subjects during his royal walkabout. The rapid spread of tuberculosis across France and England, however, necessitated a more formal and efficient touching process. By the time of Louis XIV of France, placards indicating the days and times the King would be available for royal touches were posted regularly; sums of money were doled out as charitable support. In England, the process was extremely formal and efficient. As late as 1633, the Book of Common Prayer of the Anglican Church contained a Royal Touch ceremony. The monarch (king or queen), sitting upon a canopied throne, touched the afflicted individual, and presented that individual with a coin – usually an Angel, a gold coin the value of which varied from about 6 shillings to about 10 shillings – by pressing it against the afflicted's neck.
How did TB spread?
In South America, reports of a study in August 2014 revealed that TB had likely been spread via seals that contracted it on beaches of Africa, from humans via domesticated animals, and carried it across the Atlantic. A team at the University of Tübingen analyzed tuberculosis DNA in 1,000-year-old skeletons of the Chiribaya culture in southern Peru; so much genetic material was recovered that they could reconstruct the genome. They learned that this TB strain was related most closely to a form found only in seals. In South America, it was likely contracted first by hunters who handled contaminated meat. This TB is a different strain from that prevalent today in the Americas, which is more closely related to a later Eurasian strain.
Why is TB called the robber of youth?
At the time, tuberculosis was called the robber of youth, because the disease had higher death rate among young people. Other names included the Great White Plague and the White Death, where the "white" was due to the extreme anaemic pallor of those infected. In addition, TB has been called by many as the "Captain of All These Men of Death".
What is the name of the disease that was first described in the Atharvaveda?
The oldest of them ( Rigveda, 1500 BC) calls the disease yaksma. The Atharvaveda calls it balasa. It is in the Atharvaveda that the first description of scrofula is given. The Sushruta Samhita, written around 600 BC, recommends that the disease be treated with breast milk, various meats, alcohol and rest.
When was the Tuberculosis Sanatorium regimen?
Tuberculosis sanatorium regimen in the 1940s: a patient's personal diary
Is TB a bitter disappointment?
21 FebruaryWell, it is a bitter disappointment—and, of course finish to any more family—even adopting one would have to wait a long time, till I am home again and we can, money permitting, have more help. I feel bitter and very miserable but have reached a few pretty definite conclusions. First, I think that when one has got this disease it is wise to undergo the sanatorium routine and discipline, and after a period of that, plus constant association with doctors and nurses who specialize in TB, anyone with some intelligence must surely learn how to treat oneself—and it is a bit of an insurance policy for the future, because I feel now that one can never be sure that it will not recur again.
Who developed the plan to eliminate tuberculosis?
Mason, then Director of the Centers for Disease Control, challenged the public health community to develop a strategy to eliminate tuberculosis from the United States. This plan was developed by the Centers for Disease Control/Department of Health and Human Services' Advisory Committee ...
How should the federal government evaluate the elimination of tuberculosis?
This evaluation should include an analysis of morbidity and mortality data, case reporting, case finding, treatment, and prevention activities. Annual evaluations could be done in collaboration with interested constituencies such as lung associations, minority organizations, and professional societies. Regional meetings to share information among states are encouraged. 2.Expert assessment should be conducted annually for local health departments by the state, CDC, or the American Lung Association/American Thoracic Society and for state health departments by CDC or the American Lung Association/American Thoracic Society. A similar assessment of federal tuberculosis prevention and control activities should be conducted by the CDC Advisory Committee for Elimination of Tuberculosis or other outside consultants. 3.Priority for continued federal funding of state and local programs should be, at least in part, contingent upon improved program performance and productive activities in high-risk populations. 4.A prototype computerized record system should be developed by CDC for use by local programs for case reporting, patient management, and program assessment. CDC should provide microcomputers, with appropriate software and training, to state and major city health department tuberculosis control programs in high-incidence areas. 5.Each state and major metropolitan area should develop and publish an annual community tuberculosis summary and program plan (including objectives, methods, a discussion of program progress or failure, and corrective action needed). 6.Health departments should review each new tuberculosis case and each death from tuberculosis to determine if the case or death could have been prevented had the American Thoracic Society/CDC recommendations been followed. Based on these reviews, new policies should be developed and implemented to reduce the number of preventable cases. Conclusion Implementation of Step 1 of this plan will require strong commitment at the national, state, and community levels. State and local tuberculosis advisory groups, with broad representation from public, private, and voluntary medical groups, should develop and help implement Step 1 strategies appropriate for the state or community. STEP 2 -- DEVELOPMENT AND EVALUATION OF NEW PREVENTION, DIAGNOSTIC, AND TREATMENT TECHNOLOGIES In June 1985, CDC, the National Institutes of Health, the American Thoracic Society, and the Pittsfield Antituberculosis Association cosponsored a conference in Pittsfield, Massachusetts. The objective of this conference was to identify areas for research that would lead to improved technologies for eliminating tuberculosis from the United States. The complete report of this conference was published in the August 1986 issue of the American Review of Respiratory Disease (15). Consequently, only selected priority projects are mentioned here. The five headings under which research projects and activities are listed represent critical objectives for eliminating tuberculosis. They are presented in priority order. These projects should also be regarded in terms of type of research, i.e., basic, applied, and epidemiologic/operational (Table 1). Basic research is intended to obtain a better understanding of structure, processes, and mechanisms of tuberculosis. While the findings from this research can often be applied for some clinical or public health purpose, basic research does not proceed with a specific application in mind. As already implied, applied research has as its goal the application of knowledge to the solution of a particular clinical or public health problem. Epidemiologic studies are designed to assess the magnitude, distribution, and determinants of disease in a population. Operational research studies assess the actual impact of interventions on health outcomes in the population. Improving Methods for Preventing Disease in Infected Persons The vast majority of new cases of tuberculosis arise in persons who have had a latent period of infection. The most critical element in tuberculosis elimination is the detection and treatment of infected persons before disease emerges. At present, INH is usually administered for 6-12 months for preventive therapy. However, this approach has major deficiencies. These include the expense of treating and monitoring patients for such a long time, noncompliance with preventive therapy of long duration, and the occurrence of drug toxicity, especially hepatotoxicity. The first-priority objective of Step 2 is to develop shorter, safer, more effective and more economical means of preventing the emergence of clinical disease from the infected state. Methods Areas of research to be pursued are as follows:
How is tuberculosis spread?
BACKGROUND INFORMATION Tuberculosis is a communicable disease caused by bacteria (Mycobacterium tuberculosis complex) that are usually spread from person to person through the air. When people with tuberculosis of the respiratory tract cough, airborne infectious particles are produced.
How much did the number of tuberculosis cases increase in 1985?
However, in 1985, the number of tuberculosis cases remained stable and, in 1986, cases increased by 2.6% (2,3). This increase was, at least in part, caused by the occurrence of tuberculosis among persons infected with HIV (2-4).
Why should the media publish articles on tuberculosis?
The Media a.Articles on advances in the diagnosis, treatment, and prevention of tuberculosis should be published in newspapers and magazines to educate the general public, thereby increasing support for tuberculosis programs and increasing the demand for adoption of the new technology .
How long should a health care worker visit a patient?
The health-care worker should visit the patient within 3 days of diagnosis to identify contacts and possible problems related to compliance with therapy. 2.For each new infectious case, a specific treatment and monitoring plan should be developed within 4 days of diagnosis.
Where does tuberculosis affect the body?
Although the disease usually affects the lung, it can occur at virtually any site in the body. Despite the great strides that have been made in the control of tuberculosis, the disease continues to be a public health problem in the United States.
