Treatment of tuberculosis is an important action that is aimed at suppressing dangerous bacteria. Tuberculosis is a disease that is treated with drugs. To get rid of all tuberculosis bacteria, it is necessary to take a whole range of drugs, strictly as prescribed by a doctor.
Naturally, treatment depends on the form of the disease. After all, tuberculosis can be infiltrative, disseminated, miliary. Also distinguish cavernous, fibro-cavernous and focal tuberculosis. It can be open and closed. May be acute, latent or chronic. From all this depends on the duration and method of treatment.
Treatment of both primary and secondary tuberculosis is used to kill mycobacteria. Antibacterial drug therapy is aimed at suppressing the reproduction of the causative agent of tuberculosis.
The simultaneous use of several drugs can destroy bacteria and prevent the development of drug resistance in the initial stages of treatment. Treatment of tuberculosis can be divided into 2 stages. The first is the initial and intensive phase of treatment. In this case, doctors prescribe several drugs at once (4-5). Thus, the mycobacterial population is reduced.
The second stage is the continuation phase of treatment. In this case, maintenance therapy occurs, and about 2-3 drugs are used. Part of the population is gradually collapsing. The concentration of prescribed drugs in the inflammation provides a bacteriostatic and bactericidal effect. It is worth noting that toxins affect the human body minimally. The correct simultaneous use of several drugs can shorten the course of treatment by 6-8 months.
First row drugs
First-line drugs have the maximum effect during treatment and minimal toxicity. This treatment is used for patients in whom tuberculosis was first diagnosed.
|Drug name||Pharmaceutical Group||Side effects||Who is contraindicated|
|Isoniazid||Hydrazides||Dizziness, headache, nausea, vomiting, drug-induced hepatitis. Rarely: psychosis, insomnia, neuritis.||It can not be taken to people with pulmonary heart disease, porphyria, psychosis, hepatitis, asthma, eczema, renal failure. Pregnant and lactating women should take the drug strictly as prescribed by a doctor.|
|Pyrazinamide||Synthetic antibacterial drugs||Nausea, vomiting, diarrhea, taste of metal in the mouth, abnormal liver function, rash, acne, manifestation of peptic ulcers.||Not recommended for people with gout and liver disorders.|
|Streptomycin||Aminoglycosides||Headache, convulsions, drowsiness, epileptic seizures, vestibular disorders.||It can not be taken for people with cardiovascular diseases, cerebrovascular accident, diseases of the auditory and vestibular apparatus. Children and pregnant women are prescribed the drug if indicated.|
|Rifampicin||Ansamycins||Headache, blurred vision, nausea, vomiting, diarrhea. It is also possible acute renal failure, nephritis.||Can not be taken with jaundice, infectious hepatitis, in violation of the kidneys and hypersensitivity to the drug.|
|Ethambutol||Synthetic antibacterial drugs||Visual impairment, allergic reactions.||You can not take with such diseases: neuritis, cataracts, eye diseases, pregnancy.|
Second-line drugs are not as strong as the first. They have a more toxic effect on the human body. Therefore, they are used only if mycobacterium tuberculosis is resistant to first-line drugs. Most often, this happens after the already conducted antibiotic therapy.
|Drug name||Pharmaceutical Group||Side effects||Who is contraindicated|
|Cycloserine||Antibiotics||Headache, dizziness, sleep problems, memory impairment, mental disorders.||Cannot be taken by people with CNS problems, before and after surgery. Carefully take the drug should be people with impaired renal function, the central nervous system and suffering from alcoholism.|
|Ofloxacin||Fluoroquinolones||Allergic reactions, abdominal pain, nausea, vomiting, diarrhea. There may be disturbed sleep, smell and taste.||Cannot be taken by pregnant women and women during lactation, children and adolescents. Also not prescribed medication for epilepsy.|
|Ciprofloxacin||Fluoroquinolones||Allergic reactions, abdominal pain, nausea, vomiting, diarrhea. There may be disturbed sleep, smell and taste.||Cannot be taken by pregnant women and women during lactation, children and adolescents. Also not prescribed medication for epilepsy.|
|Amikacin||Aminoglycosides||Ototoxic and nephrotoxic effect is possible.||It should not be taken for neuritis, liver and kidney dysfunction, uremia. You can not take pregnant and newborns.|
|Kanamycin||Aminoglycosides||Ototoxicity, lesions of the vestibular apparatus, neuromuscular blockade, allergic reactions, neurotoxicity. Nausea, vomiting, diarrhea are also possible.||It can not be taken with hypersensitivity to the drug, myasthenia, neuritis, botulism, intestinal obstruction and severe renal impairment.|
|Capreomycin||Glycopeptides||Electrolyte disorders, leukopenia, toxic neuritis, allergic reactions.||Contraindicated in case of hypersensitivity to the drug, children, pregnant women.|
|Protionamide||Synthetic antibacterial drugs, derivatives of isonicotinic acid||Gastrointestinal disorders, dizziness, rapid heartbeat, weakness, numbness of the extremities.||Cannot be taken by pregnant women and people with impaired kidney function.|
|Ethionamide||Synthetic antibacterial drugs, derivatives of isonicotinic acid||Gastrointestinal disorders.||Can not be taken with gastritis, gastric ulcer, colitis, liver cirrhosis, alcoholism and children under 14 years.|
|Para-aminosalicylic acid||Synthetic antibacterial drugs||Gastrointestinal disorders, leukopenia, allergic reactions, hypoglycemia, neuritis.||You can not take with kidney disease and liver, stomach and intestines. Also, the drug is not recommended for women during lactation and epilepsy.|
Reserve drugs are used when the body's resistance to first and second-line drugs or when they are intolerant.
|Drug name||Pharmaceutical Group||Side effects||Who is contraindicated|
|Rifabutin||Ansamycins||Allergic reactions, gastrointestinal disorders, myalgia, arthralgia.||Contraindicated in people with sensitivity to rifabutin, pregnant and lactating women, children.|
|Clofazimine||Ansamycins||Loss of body weight, anorexia, prolonged diarrhea. Nausea, vomiting, abdominal pain, allergic reactions.||Contraindicated in case of hypersensitivity to the components of the drug, pregnant and lactating women, children weighing less than 50 kg.|
|Clarithromycin||Macrolides and azalides||Abdominal pain, diarrhea, nausea. Leukopenia, anorexia, hypoglycemia, mental disorders, anaphylactic reactions.||Contraindicated in hypokalemia, liver and kidney failure, sensitivity to antibiotics.|
|Amoxicillin||Semisynthetic Penicillins||Allergic reactions, gastrointestinal disorders, hepatitis, jaundice, headaches, insomnia.||Contraindicated in allergies to antibiotics, infectious mononucleosis, lymphocytic leukemia.|
|Ftivazid||Hydrazides||Headaches, dizziness, sleep disturbances, neuritis. Nausea, vomiting, dry mouth, allergic skin reactions.||You can not take the drug for angina, diseases of the central nervous system, kidneys, as well as during breastfeeding.|
|Flurenizide||Synthetic antibacterial drugs, derivatives of isonicotinic acid||No side effects have been identified.||Contraindicated in case of hypersensitivity to the drug.|
|Florimitsin||Synthetic antibacterial drugs||Headache, dermatitis, nephrotoxicity, ototoxicity.||Contraindicated in hypersensitivity, neuritis, chronic renal failure.|
|Thioacetazone||Synthetic antibacterial drugs||Headache, nausea, loss of appetite, dermatitis.||You can not take the drug in violation of the kidneys and liver, diseases of the hematopoietic system.|
Combination drugs are used mainly in the treatment of newly diagnosed tuberculosis. They are not inferior in their activity to separate drugs and provide reliable control of drug intake, reducing the risk of overdose.
|Drug name||Pharmaceutical Group||Work effects||Who is contraindicated|
|Isoniazid + Rifampicin||Combined anti-TB drugs||Gastrointestinal disorders, anaphylactic shock, headache, dizziness, weakness. Angina, increased blood pressure, allergic reactions.||Contraindicated in hypersensitivity, liver failure, pregnancy. Also, you can not take the drug to children and lactating women.|
|Isoniazid + Ethambutol||Combined anti-TB drugs||Allergy, nausea, vomiting, diarrhea. Headache, sleep disturbances, dizziness.||Contraindicated in hypersensitivity, epilepsy, asthma, psoriasis, liver cirrhosis, neuritis, gout. It is also prohibited for pregnant women and women during lactation.|
|Isoniazid + Pyrazinamide + Rifampicin||Combined anti-TB drugs||Headache, dizziness, depression, sleep disorders, angina pectoris, leukopenia, myalgia, allergic reactions.||Contraindicated in jaundice, liver disease, pulmonary heart disease, pregnancy and lactation.|
|Isoniazid + Pyrazinamide + Rifampicin + Ethambutol||Combined anti-TB drugs||Anaphylactic shock, optic neuritis, dizziness, headache, gastrointestinal disorders. Increased body temperature, chills, weakness.||Contraindicated in toxic and infectious hepatitis, liver and kidney diseases, eye diseases, and epilepsy.|
The purpose of surgical intervention for tuberculosis is the solution of certain tasks. This is the elimination of tuberculosis foci in the lungs with ineffective treatment, the elimination of the effects of pulmonary tuberculosis, the elimination of organ damage in order to prevent recurrence of the disease. It also includes improving the quality of life and reducing the level of epidemic danger. It is important to understand that no task can be solved without an integrated approach. Indications for surgery can be any form of respiratory tuberculosis, especially in the case of complications that threaten human life.
Any form of this disease can be an urgent indication for surgery at any stage of treatment. Therefore, all newly diagnosed infected must understand and be prepared for the possible use of a surgical treatment method.
First, the patient must be diagnosed, after which the attending physician assesses the condition of the organ, cardiac activity and other important points. The task of the doctor is also to study the list of drugs prescribed to patients. If we are talking about pulmonary tuberculosis, the doctor performs an opening of the chest and then, depending on the situation, removes the completely affected organ or area.
Chemotherapy in the fight against tuberculosis
Chemotherapy of tuberculosis is a therapy that is used with the optimal combination of anti-tuberculosis drugs aimed at eliminating mycobacteria and suppressing their reproduction.
The effectiveness of this method largely depends on the duration of the entire treatment. For example, during the first chemotherapy, the duration of treatment was relatively short - from 1 to 3 months. Now the duration of such treatment increases each time and can even reach a year.
If you stop chemotherapy early, exacerbation or complications of tuberculosis may occur. Therefore, it is important that the doctor correctly determines the optimal timing of chemotherapy and in the preparation of a treatment plan, and in the process of the treatment itself.
The effects of tuberculosis treatment with chemotherapy can be either positive or negative. Negative consequences are the occurrence of adverse reactions of the human body to the use of drugs. Most often, adverse reactions occur in about 10–15 percent of patients. Basically there are 2 types of adverse reactions: toxic and allergic. Sometimes it is difficult to identify and understand them, then we are talking about the toxic-allergic form. Dysbacteriosis can also occur, but it does not come in any form.
Tuberculosis is a disease that is very difficult to beat until the end. The treatment of this disease can last a very long time: a month, a year, and even more. At the same time, the patient must take at least four kinds of serious drugs at the same time. It is known how antibiotics and chemotherapy drugs adversely affect the entire human body, destroying its cells and causing allergic reactions. Therefore, simultaneously with the treatment of tuberculosis with drugs, it is important to protect other important organs of a person who is sick. In this case, folk remedies are perfect.
Treatment of tuberculosis with folk remedies is aimed at improving the patient’s immune system.
At home, treatment for tuberculosis can be a variety of methods. To quickly defeat tuberculosis, traditional medicine offers affordable and familiar recipes made from plain milk, butter, chicken eggs, and similar animal products. Also, the treatment can not do without the unloved of all fish oil. In the pharmacy, you can buy vitamin A and vitamin D. They help strengthen the immune system and are especially useful in infectious diseases.
Tuberculosis can be cured with fresh milk. The principle is simple: to do this, drink about 1 liter of fresh milk during the day. This method is very effective in pulmonary tuberculosis and bronchial disease. It should be understood that for people who are allergic to dairy products, this method will not work. Also saved from the disease with the help of badger fat, koumiss. Some people tend to treat dog meat, based on the fact that this animal does not have tuberculosis.
Is it possible to get rid of this terrible disease by means of plant origin? Today, there are many recipes for decoction of herbs. Some recipes can be prepared independently from the available ingredients, some tinctures and herbs can be bought at the pharmacy. In addition, they make medicine from a bear, a moth, a plantain and wormwood. Some are treated with pine pollen, others resort to honey and propolis. There are many recipes, each person can try something.
Garlic is an effective and affordable tool that contributes to the treatment of tuberculosis at home.The most affordable method is to eat 1-2 cloves of garlic every 2 hours. You can also make an infusion: crush a few cloves of garlic and add water. Carefully this method should be treated by people with gastrointestinal problems. You should also remember about the unpleasant smell, which publishes garlic.
In the pharmacy, you can buy elecampus, oregano, St. John's wort. For example, devasil helps a lot with bronchitis and tuberculosis. The roots of elecampane are used as an expectorant: 1 tablespoon per 200 ml of hot water. It is not recommended to take this herb for people with cardiovascular, kidney problems. Also, care should be taken if people are hypersensitive to biologically active ingredients.
The possibility of outpatient treatment of tuberculosis is considered depending on the state of health of the patient. A doctor can prescribe an outpatient treatment in the event that the disease is detected at an early stage and there is no infection for others. Outpatient treatment involves regular visits to the doctor to monitor health and conduct the necessary tests and research. This includes the complex intake of drugs, the regular conduct of all research, physiotherapy activities.
Most often, the patient is transferred to outpatient treatment after observation in the hospital and undergoing an extensive course of therapy in the TB dispensary. After the treatment, the patient does not pose any threat to others and can lead a normal life.
Inpatient involuntary treatment of tuberculosis is the first stage of long-term treatment, which requires serious efforts from patients. A person will have for some time to break away from the usual way of life with family and loved ones, get used to a new place, the rules and the constant intake of drugs. And this, unfortunately, is not a couple of days.
Hospitalization takes place in the case of an acute form of the disease or in case of a risk of infection of others. The duration of inpatient treatment can reach 3 months. There are cases when the patient is discharged in a month. This time may be enough to stop the development of mycobacteria and eliminate the possibility of infection of other people. It is extremely important to be hospitalized in a hospital if a human body is intoxicated, since it is very dangerous for the patient's life.
Spa treatment is quite popular. This is due to the epidemiological situation and the possibility of achieving high results of such treatment. You need a spa treatment in the case when it is impossible to do without hospitalization. Clinical cure for the disease in the sanatorium is observed in approximately 80 percent of tuberculosis patients, and improvement in functional parameters is observed in almost every patient.
The main methods of climatotherapy are aerotherapy, heliotherapy and bathing. Each species activates all sorts of adaptation mechanisms. At the same time, almost all of them are reflected in the state of the cardiovascular and neuroendocrine systems.
Thermal effects definitely affect the respiratory system. Aerotherapy affects the respiratory and hematopoietic organs. Heliotherapy affects the condition of the skin and connective tissue. At the same time, most factors affect the overall immune system. The application of one method or another is determined by the designated sanatorium-climatic regime and depends on the patient's state of health.
Features of the treatment of extrapulmonary tuberculosis
Tuberculosis can affect not only the lungs, but also other vital organs. This applies to the stomach, and female organs, and the genitourinary system, and lymph nodes, and throat. At the same time among the female organs most often suffer uterine tubes, cervix. In men, the prostate.
In the urogenital system most often there is a problem with the bladder.
Therapy of extrapulmonary tuberculosis in identifying any form of the disease should be carried out comprehensively. This may require anti-TB drugs, immobilization of the patient and surgery. Each form is treated in its own way and each has its own characteristics.
For example, with brain tuberculosis, surgery is contemplated. Lymph nodes can be cured with chemotherapy or through surgery.
If you diagnose tuberculosis of the kidneys or liver in time, and start treatment, then the prognosis will be good. If the disease is detected late, then apply chemotherapy and surgery. In rare cases, the removal of an organ is indicated.
In case of detection of joint and bone tuberculosis, complex treatment is most often used, which includes a conservative and surgical method. Treatment of osteo-articular tuberculosis and spinal tuberculosis is a serious matter. Revealed eye tuberculosis needs treatment with antibacterial drugs. Pathogenetic therapy may also be prescribed.
Organs and parts of the body that can affect tuberculosis mass. This may be inflammation of the pleura, there may be a problem with the thyroid gland. It is necessary to undergo tests in time to prevent the occurrence of extrapulmonary tuberculosis.
Duration of therapy
Treatment of tuberculosis can last from 2 to 6 months, it depends on the treatment regimen. Further treatment lasts from 4 months to 1 year. In more severe cases, the term may last up to 2 years or more. The duration of treatment is affected by the patient’s condition, the form of tuberculosis, the conditions and adverse conditions. It also matters who is being treated: children, adolescents or adults.
Is full recovery possible?
Tuberculosis is not a sentence, so full recovery is possible. Yes, it is a serious and dangerous disease, but it is treatable. His success depends directly on the patient. If a person asked for help at the first unusual symptoms and observes all instructions of the doctor, then his chances of recovery are very high. Modern medicine guarantees a complete cure in about 80 percent of cases.
Is tuberculosis dangerous after recovery?
After recovery, it is important to maintain a healthy lifestyle, give up all bad habits (first of all, it's smoking), eat right. It is also very important if necessary to carry out preventive measures in order to exclude the recurrence of the disease. If you follow all the simple general rules, then tuberculosis will not be dangerous for a person, and the person will not be contagious for other people.
Who to contact at the first symptoms
Treatment of pulmonary tuberculosis is engaged in a TB doctor. If we are talking about extrapulmonary forms, then you should contact the doctors who are engaged in the treatment of an organ. Initially, a person can turn to a therapist who, after hearing all the complaints, will refer to the right specialist.
Specialty: pediatrician, infectious diseases specialist, allergist-immunologist.
Total experience: 7 years.
Education: 2010, SSMU, pediatric, pediatrics.
Experience infectious diseases more than 3 years.
He has a patent on the topic “A method for predicting a high risk of the formation of a chronic pathology of the adeno-tonsillar system in frequently ill children”. As well as the author of publications in the journals of the Higher Attestation Commission.