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TB Treatment

How is latent TB infection treated?

Latent TB infection is treated with isoniazid, which is one of the first-line anti-TB drugs. The recommended length of treatment is nine months for adults and children. Shorter courses of treatment with other first-line drugs may be used for special circumstances, such as exposure to someone who has TB that is resistant to isoniazid.

Sometimes people are given preventive therapy even if their skin test reaction is not positive. This is often done with infants, children, and HIV-infected people who have recently spent time with someone with infectious TB disease. This is because they are at very high risk of developing TB disease soon after they become infected with TB bacteria.

It is important that you take all the pills prescribed for you so that your preventive therapy is effective. If you start taking INH, you will need to see your doctor or nurse on a regular schedule. He or she will check on how you are doing. Very few people have serious side effects to INH. However, if you have any of the following side effects, call your doctor or nurse right away:

  • no appetite

  • nausea

  • vomiting

  • yellowish skin or eyes

  • fever for more than 3 days

  • abdominal pain

  • tingling in the fingers and toes

How is TB disease treated?

There is good news for people with TB disease! TB disease can almost always be cured with medicine. But the medicine must be taken as the doctor or nurse tells you.

The most common drugs used to fight TB are:

  • isoniazid (INH)

  • rifampin

  • pyrazinamide

  • ethambutol

  • streptomycin

If you have TB disease, you will need to take several different drugs. This is because the bacteria can quickly become resistant if only one drug is given. Taking several drugs will do a better job of killing all of the bacteria and preventing them from becoming resistant to the drugs.

If you have TB of the lungs or throat, you are probably infectious. You need to stay home from work or school so that you don't spread TB bacteria to other people. After taking your medicine for a few weeks, you will feel better and you may no longer be infectious to others. Your doctor or nurse will tell you when you can return to work or school.

Having TB should not stop you from leading a normal life. When you are no longer infectious or feeling sick, you can do the same things you did before you had TB. The medicine that you are taking should not affect your strength, sexual function, or ability to work. If you take your medicine as your doctor or nurse tells you, the medicine will kill all the TB bacteria. This will keep you from becoming sick again.

Why do I need to take TB medicine regularly?

TB bacteria die very slowly. It takes at least 6 months for the medicine to kill all the TB bacteria. You will probably start feeling well after only a few weeks of treatment. But beware! The TB bacteria are still alive in your body. You must continue to take your medicine until all the TB bacteria are dead, even though you may feel better and have no more symptoms of TB disease.

If you don't continue taking your medicine after you feel better or you aren't taking your medicine regularly, this can be very dangerous. The TB bacteria will grow again and you will remain sick for a longer time. The bacteria may also become resistant to the drugs you are taking. You may need new, different drugs to kill the TB bacteria if the old drugs no longer work. These new drugs must be taken for a longer time and usually have more serious side effects.

If you become infectious again, you could give TB bacteria to your family, friends, or anyone else who spends time with you. It is very important to take your medicine the way your doctor or nurse tells you.

How can I remember to take my medicine?

The only way to get well is to take your medicine exactly as your doctor or nurse tells you. You will be taking your medicine for a long time (6 months or longer), so you should get into a routine. Here are some ways to remember to take your medicine:

  • Participate in the directly observed therapy (DOT) program at your county health department.

  • Take your pills at the same time every day -- for example, you can take them before eating breakfast, during a coffee break, or after brushing your teeth.

  • Ask a family member or a friend to remind you to take your pills.

  • Mark off each day on a calendar as your take your medicine.

  • Put your pills in a weekly pill dispenser. Keep it by your bed or in your purse or pocket.

The best way to remember to take your medicine is to get directly observed therapy (DOT). If you get DOT, you will meet with a health care worker every day or 2 or 3 times a week. You will meet at a place you both agree on. This can be the TB clinic, your home or work, or any other convenient location. The health care worker will watch you take your medicine.

DOT helps in several ways. The health care worker can help you remember to take your medicine and complete your treatment. This means you will get well as soon as possible. With DOT, you may need to take medicine only 2 or 3 times each week instead of every day. The health care worker will make sure that the medicine is working as it should. This person will also watch for side effects and answer questions you have about TB.

Even if you are not getting DOT, you must be checked at different times to make sure everything is going well. You should see your doctor or nurse regularly while you are taking your medicine. This will continue until you are cured.

If you forget to take your pills one day, skip that dose and take the next scheduled dose. Tell your doctor or nurse that you missed a dose. You may also call your doctor or nurse for instructions.