Mycobacterium tuberculosis is responsible for tuberculoss and it’s very difficult to eradicate because it is slow growing. We could however, cure tuberculosis.
- Slow growing organism
- Difficult to eradicate
- Mycobacterium tuberculi can be cured
We have to make sure patients are compliant. Treatment is going to go on for a long period of time. If a patient decides to not be compliant, the organism becomes resistant. We have 4 drugs in this list and in the market there’s only a total of 8.
- Isoniazid (INH) – p.o.
- Streptomycin – inj
- Rifampin (Rifadin) – p.o.
- Ethambutol (Myambutol) – p.o.
The basic rule is that if the disease is minimal to moderate they’re going to be on 2 drugs for 2 years.
If it’s advanced (disseminated; spread widely), then that’s going to require 3 drugs for 3 years.
If they are non compliant it’s gotta be different and we gotta try something else. If they are non compliant again, then it’s going to be very difficult because we have only so many drugs to choose from in the first place!
Health care professionals must have a TB skin test every year. If the test result is positive, it means they have been exposed to tuberculosis but that doesn’t mean they have an infection. Since these drugs are potentially hepatotoxic, if the person is young and healthy, they will be put on the drugs for 9 months. If the person is at a high risk for complication from these drugs, they will just have to be carefully monitored.
Note: In the US, we don’t use the BCG vaccine because then you’d automatically show up positive for any TB test automatically and then you’d need a chest X-ray or CAT scan to confirm you don’t have a tuberculosis infection every time! People from third world countries are well aware of this.
- Non-compliance leads to resistance
- Minimal to moderate disease requires two drugs for two years
- Advanced (disseminated) disease requires three drugs for three years
- Most medications are hepatotoxic.
- Prophylactic therapy for 9-12 months for healthy, positively identified carriers.