why is tb treatment so long

A fundamental problem in the treatment of tuberculosis (TB) is the long duration of therapy required for cure. The recalcitrance of Mycobacterium tuberculosis

(MTB) to eradication is thought to result from its achieving a nonreplicating (dormant) state in the host.

Full Answer

Why is tuberculosis (TB) so hard to cure?

A fundamental problem in the treatment of tuberculosis (TB) is the long duration of therapy required for cure. The recalcitrance of Mycobacterium tuberculosis(MTB) to eradication is thought to result from its achieving a nonreplicating (dormant) state in the host.

How long does it take to cure tuberculosis in India?

It also depends upon the infection area in the body. conventional regimes DOTS under Rntcp in india take 6 months for drug sensitive TB , 18 months for resistant Tb and 24 months for extensive drug resistant Tb . , Extensive Personal Research on Tuberculosis.

What happens if you have drug resistant tuberculosis (TB)?

If they already have drug resistant TB, then the treatment that someone is provided with may result in treatment failure even if the treatment is taken correctly.

How many drugs does it take to cure tuberculosis (TB)?

Patients with active TB disease should receive at least three drugs as their initial TB treatment. Fewer than three drugs can result in the development of drug resistant TB. If a patient is failing their treatment this means that they are either developing TB symptoms again, or their symptoms are not going away at all.

Why is the treatment for tuberculosis so long?

Scientists have assumed that mycobacteria are so hard to kill because dormant cells exist even in patients with active disease and these cells are far less susceptible to antibiotics than metabolically active bacteria.

Why is TB treated for 6 months?

Taking medication for 6 months is the best way to ensure the TB bacteria are killed. If you stop taking your antibiotics before you complete the course or you skip a dose, the TB infection may become resistant to the antibiotics.

Why is treatment of TB so difficult?

TB is difficult to diagnose and drug resistance takes a long time to determine because the bacteria grows so slowly. Most bacteria double in 20 minutes—TB takes 24 hours. So it takes 24 hours to get 2 bacteria, 48 hours to get 4, and so on. Treatment for MDR-TB can take up to two years and cost up to $250,000.

How long will TB treatment last?

After taking TB medicine for several weeks, a doctor will be able to tell TB patients when they are no longer able to spread TB germs to others. Most people with TB disease will need to take TB medicine for at least 6 months to be cured.

Can tuberculosis come back after treatment?

A recurrence of TB can be due to relapse or re-infection [1]. To prevent relapse, TB treatment guidelines in the United States (U.S.) recommend extended treatment for TB cases with cavities on chest radiograph and delayed bacterial clearance from sputum [2]. Re-infection is prevented when TB transmission is averted.

Can TB be cured in 5 months?

Tuberculosis treatment for people without drug resistance can be shortened from six months to four months by replacing two drugs in the standard regimen with newer agents (high-dose rifapentine and moxifloxacin), results from a large international trial show.

Why mycobacterial infections have to be treated for 6 months or longer?

If treatment is not continued for a long enough duration, the surviving bacteria may cause the patient to become ill and infectious again, potentially with drug-resistant disease.

What are the 3 biggest challenges to effective TB treatment?

Five deadly barriers to effective TB careFive key strategies.Barrier 1: Toxic Treatment. ... What kind of DR-TB treatment is needed? ... Barrier 2: Unidentified TB cases. ... How do we find more TB cases? ... Barrier 3: Lack of social support. ... Solution: ... Barrier 4: Centralized drug-resistant TB (DR-TB) care.More items...•

Is TB 100 percent curable?

Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable.

Can lungs heal after TB?

Treatment of drug-susceptible pulmonary TB is highly effective, with 85% (66 million cases) of reported cases estimated to have been successfully treated between 1995 and 2015 [1]. However, up to half of TB survivors have some form of persistent pulmonary dysfunction despite microbiologic cure [2–5].

Is TB treatment painful?

Pyrazinamide has a strong action against the Tuberculosis bacteria in the early stages of treatment. Common side effects include loss of appetite, nausea and flushing. Some people experience pain in their joints. This is usually mild and painkillers such as aspirin or paracetamol will ease the pain.

Does tuberculosis stay in your system forever?

Many people who have latent TB infection never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have a weak immune system, the bacteria become active, multiply, and cause TB disease.

How long do you have to take antibiotics for TB?

advertisement. Patients with TB typically have to take 4 antibiotics for 2 months and then continue 2 of these antibiotics for an additional 4 months. Why is such long treatment needed? Lalita Ramakrishnan (University of Washington) and colleagues say that traditionally the answer was thought to lie in the fact that the tuberculosis microbe ...

Why is TB resistant to antibiotics?

Because virtually all types of antibiotics act only on replicating bacteria, the dormant state of TB is thought to render it resistant to treatment. But the authors now challenge this traditional view.

Is TB a non-replicating disease?

In the light of data on treating human TB and other bacterial infections, they suggest that the non-replicating state is not TB-specific and that the number of non- replicating bacteria correlates with total bacterial burden rather than TB-specific pathology.

Why is TB a fundamental problem?

A fundamental problem in the treatment of tuberculosis (TB) is the long duration of therapy required for cure. The recalcitrance of Mycobacterium tuberculosis (MTB) to eradication is thought to result from its achieving a nonreplicating (dormant) state in the host. Because virtually all classes of antibiotics require bacterial replication ...

Does TB have a correlation with time to cure?

This correlation between bacterial burden and time to cure is not unique to TB, as it has been found in other bacterial infections, both acute and chronic. High bacterial burden infections, in turn, are associated with an increased frequency ...

Is pyrazinamide effective against TB?

The role of pyrazinamide in shortening TB therapy to six months may also suggest the existence of a nonreplicating population in vivo, as, unlike other anti-TB drugs, pyrazinamide is more active against nonreplicating than actively replicating MTB in vitro [ 13, 14 ].

What is delayed diagnosis and treatment of tuberculosis?

Delayed diagnosis and treatment of tuberculosis contributes to the spread of the disease. In this study, we aimed to determine the patient and healthcare system delay among tuberculosis patients in Portugal and identify associated factors at individual and contextual level.

How many cases of TB worldwide in 2016?

Tuberculosis (TB) is a major public health problem: in 2016 there were an estimated 10.4 million cases worldwide. 1 Despite the 22% decrease in the number of deaths between 2000 and 2015, TB is still one of the ten main causes of death worldwide. 1 In 2015, the number of TB notifications in Europe represented 3% of notifications worldwide. 2 Portugal stands out in the western European context for having one of the highest TB rates. 2 In 2016, there were 1836 TB notifications in Portugal, representing a notification rate of 17.8 per 100,000 habitants. 3 The End Tuberculosis Strategy, by the World Health Organization (WHO), aims to reduce the TB incidence rate by 90% and the number of deaths by 95% until 2035. 1 Despite the decrease in the TB incidence in the last fifteen years, the current decline rate is still insufficient to achieve the WHO target. 1

How long does TB treatment last?

For new patients with presumed drug susceptible pulmonary TB, the World Health Organisation (WHO) recommends that they should have six months of treatment. This consists of a two month intensive phase followed by a four month continuation phase.

Why does TB treatment fail?

It is often suggested that TB treatment fails because a patient doesn’t take their TB drugs correctly. However there can be a number of different reasons for TB treatment failure. It is certainly true that if a patient doesn’t take their TB drugs properly that this can lead to the development of drug resistant TB.

What are the best drugs for TB?

The drugs that a patient should take depends on whether the patient has ever had TB treatment before. If the patient has never had treatment before then it can be assumed that the bacteria in the patient's body will respond, and be sensitive to all the TB drugs. So the patient can then be given the following drugs: 1 Isoniazid 2 Rifampicin 3 Pyyrazinamide 4 & Ethambutol.

What is the responsibility of a doctor for TB?

A patient must take their drugs properly. But it is also the responsibility of the doctor to make sure that the patient has the correct drugs. The doctor must also explain to the patient how to take the drugs correctly. In many countries there are "alternative" medicines available.

How many drugs are there for TB?

There are more than twenty drugs available for TB treatment. Which ones have to be taken depends on the circumstances of the patient. If you are having TB treatment (sometimes known as antitubercular treatment or ATT), then this should always be supervised by an experienced doctor or other health person.

What happens if you take only one or two TB drugs?

If only one or two TB drugs are taken then only some of the bacteria may be killed. They may then become resistant to the TB drugs which then don't work. If the person becomes sick again then different TB drugs called second line drugs may be needed.

How often should I take isoniazid?

Isoniazid. plus rifampicin. for the continuation treatment phase. It is recommended that patients take the TB drugs every day for six months. Taking the drugs three times a week used to be considered satisfactory but is no longer recommended by the WHO. It is essential that all the recommended TB drugs are taken.

How long does it take for TB to kill?

For TB disease, it takes even longer and at least 6 months for the medicines to kill all the TB germs.

What is the cause of TB?

Tuberculosis (TB) is caused by bacteria called Mycobacterium tuberculosis (M. tuberculosis). The bacteria, or germ, usually attack the lungs. TB germs can attack any part of the body, such as the kidney, spine, or brain. There is good news. People with TB can be treated if they seek medical help.

How many people with LTBI will develop TB?

While not everyone with LTBI will develop TB disease, about 5–10% will develop TB disease over their lifetimes if not treated. Progression from untreated LTBI to TB disease is estimated to account for approximately 80% of U.S. TB cases. Some people who have LTBI are more likely to develop TB disease than others.

What does a negative TB test mean?

A negative TB blood test means that your blood did not react to the test and that you likely do not have TB infection. TB blood tests are the recommended TB test for: People who have received the bacille Calmette–Guérin (BCG) TB vaccine.

How to get rid of TB in the air?

Put a fan in your window to blow out (exhaust) air that may be filled with TB germs. If you open other windows in the room, the fan also will pull in fresh air. This will reduce the chances that TB germs will stay in the room and infect someone who breathes the air. Remember, TB is spread through the air.

How does TB spread?

The TB germs are spread into the air when a person with infectious TB disease of the lungs or throat coughs, speaks, or sings. People nearby may breathe in these TB germs and become infected. When a person breathes in TB germs, the TB germs can settle in the lungs and begin to grow.

How long does it take to get a second skin test for TB?

You may need a second skin test 8 to 10 weeks after the last time you spent time with the person with TB disease. This is because it can take several weeks after infection for your immune system to react to the TB skin test. If your reaction to the second test is negative, you probably do not have TB infection.

Why is latent TB important?

Treatment of latent TB infection is essential to controlling TB in the United States because it substantially reduces the risk that latent TB infection will progress to TB disease.

How many people have latent TB?

In the United States, up to 13 million people may have latent TB infection. Without treatment, on average 1 in 10 people with latent TB infection will get sick with TB disease in the future. The risk is higher for people with HIV, diabetes, or other conditions that affect the immune system.

What is a TST reaction?

People with a tuberculin skin test (TST) reaction of 5 or more millimeters who are: HIV-infected persons. Recent contacts to a patient with active TB disease. Persons with fibrotic changes on chest radiograph consistent with old TB. Organ transplant recipients.

Can TB be treated with LTBI?

Persons with no known risk factors for TB may be considered for treatment of LTBI if they have either a positive IGRA result or if their reaction to the TST is 15 mm or larger. However, targeted TB testing programs should only be conducted among high-risk groups.

Where is TB common?

From countries where TB is common, including Mexico, the Philippines, Vietnam, India, China, Haiti, and Guatemala, or other countries with high rates of TB. (Of note, people born in Canada, Australia, New Zealand, or Western and Northern European countries are not considered at high risk for TB infection, unless they spent time in a country ...

Can TB spread to others?

People with latent TB infection do not have symptoms, and they cannot spread TB bacteria to others. However, if latent TB bacteria become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease.

How long does it take for TB to heal?

TB can be cured in six to nine months. TB takes a long time to get cured than other bacterial infections. It depends on your age, if you are young then healing process would be fast and if you are about mid-'50s then it would take more time to get recover. It also depends upon the infection area in the body.

How long do you have to take rifamcyin for pulmonary tuberculosis?

also if you don’t take medications properly it can then convert into XDR or TDR. pulmonary tuberculosis to cure it you have to take the medications for 6 months which include rifamcyin,ethambutol,pyzinamide. Multi Drug Resistance tuberculosis.

What is MDR TB?

Multi Drug Resistance tuberculosis. (MDR-TB) if you don’t take the medication or stop it or your immune system is too weak. it can become resistant to first line of antibiotics which would result in treatment upto extra 24months.

Can TB be cured in a dormant state?

Also during Dormant state mTB encapsules itself in Caseous Granuloma which is permeable only to food requ. Once active it is very difficult to cure TB. Many times patients feel cured by taking medication, but still they may harbor these bacteria in Dormant state inside their body.

Do you need to take thyroid medicine if your thyroid is unbalanced?

Since my thyroid also deteriorated during this time, I had to take his medicine but if your thyroid is less unbalanced, then there is no need to take thyroid medicine.