Tuberculosis (TB) is a deadly contagious disease, which spreads through the air. When infectious people cough, sneeze, talk, or spit, they release TB germs, known as bacilli, into the air. One needs to inhale only a small number of these to get infected. TB most commonly attacks the lungs but can also affect the lymphatic system, central nervous system, circulatory system, genitourinary system, bones, joints, and even the skin. This disease has infected one-third of the world's current population. Everyone who is infected does not develop the disease, and latent infection without the development of symptoms is a common occurrence. One in ten latent infections tend to progress to the active disease, which if left untreated, is fatal for a majority of its victims.
With proper treatment, there are good chances of recovery. Three important things need to be followed:
- The regimen must include many drugs to which the organisms are susceptible.
- The patient must take the medication on a regular basis.
- Therapy must continue for a sufficient amount of time.
Majority of the TB patients are curable. However, they should not take too little medicine or stop the medication before the prescribed period. This can lead to a drug-resistant strain of TB which is extremely difficult to cure.
The most common medications used to treat active TB include:
- Isoniazid (INH)
- Rifampin (RIF)
Isoniazid is one of the most common drugs used for TB. Inexpensive, effective, and easy to take, it can prevent most cases of TB, and when used in conjunction with other drugs, it can cure TB. INH-preventive treatment is recommended for individuals who have:
- A close contact with a person with infectious tuberculosis.
- A positive tuberculin skin test reaction and an abnormal chest X-ray that suggests inactive TB.
- A tuberculin skin test that changed from negative to positive within the past 2 years.
- A positive skin test reaction and a special medical condition (for example, HIV infection or diabetes), or who are on corticosteroid therapy, and even with none of the above risk factors in those under 35.
Isoniazid and rifampin are the keystones of treatment but because of increasing resistance to them, pyrazinamide, streptomycin sulfate, or ethambutol HCL are added to the regimens. If the patient is unable to take pyrazinamide, a 9-month regimen of isoniazid and rifampin is recommended.
➜ Even if susceptibility testing reveals that the patient is infected with an isoniazid-resistant strain, the isoniazid component is continued because some organisms may yet be sensitive. In addition, two drugs to which the organisms are likely to be sensitive are also incorporated into the regimen.
➜ The starting stage of treatment is critical for preventing the emergence of drug resistance and ensuring a good outcome. Drug resistance may be either primary or acquired. Primary resistance occurs in patients who have had no previous antimycobacterial treatment. Acquired resistance occurs in patients who have been treated in the past, and it is usually a result of non-adherence to the recommended regimen or incorrect prescribing.
➜ It has been estimated that one in seven cases of TB is resistant to drugs that previously cured the disease. Resistance arises when patients fail to complete their drug therapy, lasting six months or longer. The hardiest TB bacteria are allowed to survive as a result, and as they multiply, they spread their genes to a new generation of bacteria and to new victims. For a person with latent TB, a cure usually comes after at least 6 months of treatment with isoniazid.
Most people in the developing world don't have access to TB drugs, which leads to unnecessary fatalities. Because of improper consumption of drugs, strains of TB develop that are resistant to drug treatment. Therefore, we all should try our level best to increase awareness on this debilitating disease.
Disclaimer: This Buzzle article is for informative purposes only and should not be used as a replacement for expert medical advice.