What Are the Treatments for Pulmonary Tuberculosis?

Pulmonary tuberculosis is the term used for the presence of the bacterium Mycobacterium tuberculosis in the tissue of the lungs. Infection with this contagious bacterium can produce either active disease or a latent condition that can remain dormant for years. While infection rates in the U.S. are at an all-time low, nearly 2 billion people worldwide have some form of the disease. Treatment for pulmonary tuberculosis varies according to age, health and the form of infection present.

Understanding and Treating Latent Infection

• Latent infections of pulmonary tuberculosis are essentially held in check by the body's immune system, and are neither harmful nor contagious. However, the tuberculosis bacterium will remain in the body unless it is actively eliminated, and lowered immune function or other health problems may trigger active infection in the future. Treating latent tuberculosis is therefore just as important as treating active forms.

  If you are diagnosed with a latent infection, your doctor will likely prescribe the medication isoniazid. This drug is typically given either daily or twice weekly for a period of 9 months. Unfortunately, long-term isoniazid use carries considerable risk of liver damage through hepatitis, so you will need to safeguard yourself from other liver stresses during treatment by strictly limiting or avoiding the use of alcohol or acetaminophen products such as Tylenol. As with all tuberculosis cases, it is vital that you finish the full course of drug treatment.

Treating Active Infection

• Active pulmonary tuberculosis is both contagious and potentially fatal. Treatment centers around the simultaneous use of four medications: isoniazid, ethambutol (Myambutol), pyrazinamide and rifampin (Rifadin). While your initial treatment will almost certainly contain this combination, it is quite common for one or more of these drugs to lose effectiveness during treatment. If this is the case, your doctor will adjust your medication with the goal of maintaining treatment with more than one drug. If your problems in this area are minimal, you may be eligible to take a medication such as Rifater, which combines doses of pyrazinamide, isoniazid and rifampin in a single tablet.

  Be aware that all tuberculosis medications carry liver risks similar to those for isoniazid. In addition, rifampin use can cause side effects similar to severe flu (nausea, vomiting, muscle pain, chills and fever). Additional serious possible side effects of combined drug treatment include jaundice (yellowed skin and eye whites), darkened urine, loss of appetite, blurred vision and abdominal tenderness. Contact your doctor immediately if any of these complications develop.

Treating Drug-Resistant Cases

• There is a possibility your active tuberculosis is drug-resistant, meaning it cannot be cured using the usual combination of medications. If this is the case, your doctor will work to devise a new combination of effective drugs. In a worst-case scenario, drug resistant tuberculosis may require surgery to remove non-responsive areas of lung tissue. In some rare cases, even these measures are insufficient to halt the disease.

Treating Pregnant Women and Children

• Tuberculosis treatment varies somewhat for pregnant women and children. If you are pregnant, pyrazinamide use will be avoided. Treatment for children requires a substitute for ethambutol. Streptomycin is sometimes used for this purpose.