What Are the Treatments for Active Tuberculosis?

Tuberculosis, also known as TB, is a bacterial infection primarily affecting the lungs. Most people who become infected with the tuberculosis bacteria, called mycobacterium tuberculosis, do not have symptoms. Patients with no symptoms have latent tuberculosis and patients with symptoms have active tuberculosis. Active TB is contagious and latent TB is not.

Causes

• Active TB is caused by breathing contaminated air into your lungs, where the bacteria cause large cavities to form. This creates a breeding ground for the bacteria to survive and spread to the rest of the lung and to other organs within the body. TB can also remain inactive in your lungs for years. Illness or lowered immunity occurs and the bacteria will start to multiply again causing active TB.

Symptoms

• Active tuberculosis symptoms will include fatigue, fever, weight loss, chills and night sweats. Symptoms affecting the lungs will include persistent coughing lasting more than three weeks, coughing up blood and pain when coughing or breathing. Active TB can also affect other parts of your body and symptoms will occur in those regions, such as back pain when affecting the spine and bloody urine when affecting the kidneys.

Diagnosis

• A skin test called the Mantoux test uses a substance called PPD tuberculin to be injected under your skin. After 48 to 72 hours, your doctor will inspect the injection site for a reaction. A hard red bump indicates infection. Blood tests can confirm diagnosis and X-rays or CT scans will reveal if you have active TB by showing white spots or cavities in the lungs.

Treatment

• Treatment for active TB will start with a combination of four medications, isoniazid, rifampin, ethambutol and pyrazinamide. You may drop a medication if tests show it is ineffective, but you will continue taking several medications. You may be hospitalized at first until you are determined to no longer be contagious. Generally these drugs will be taken over a six to nine month period, but the length of time will vary depending on several factors such as age, health and drug resistance.

Treatment For Children And Pregnant Women

• Children will be given the same medications as adults except for the ethambutol because of the risk of vision problems. Streptomycin will be given in its place.

  Pregnant women will take all medications except the pyrazinamide because effects on the unborn child are unknown.

  Completion of all drugs is essential for a successful outcome. Stopping treatment before completion may cause the TB bacteria to become drug resistant. These types of bacteria become more difficult to treat and may be fatal.