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Treatment For TB
Introduction
TB can be curable, and you can make a full recovery, as long as you complete all of your treatment.
- People can still die from TB if it is not treated properly or if treatment is stopped early. Although you may start to feel better 2 or 3 weeks after starting your treatment you must complete the whole course of treatment.
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Active TB
If you have active TB you will need to be treated with special antibiotics. A combination of antibiotics is always used to reduce the risk of TB becoming resistant to one (or more) of the drugs.
In the UK the standard treatment for active TB is a combination of:
- 3 or 4 antibiotics for 2 months. These are usually isoniazid, rifampicin, pyrazinamide and ethambutol.
Followed by a combination of:
- 2 antibiotics for a further 4 months (or longer). These are usually isoniazid and rifampicin.
You may be given vitamin B6 (pyridoxine) when being treated with isoniazid to minimise potential side effects. Your treatment will last at least 6 months but may take as long as a year.
If you do not complete your full course of treatment your TB may come back in a 'drug–resistant' form. When this happens your TB will be more difficult to treat as the usual TB antibiotics will not work.
It is now common to be treated for TB at home. You will not usually be admitted to hospital unless there is a clear need for this, e.g. you are very unwell, you are homeless or your living conditions are unsafe, or your treatment has been sanctioned by a court order.
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Latent TB
Some people with latent TB can go on to develop active, infectious TB at some point in the future. So, if you are diagnosed with latent TB your doctor will assess you to see whether you need treatment.
In general, you will be offered treatment for latent TB if:
- You are under 36 years old
- You are over 36 years old and a healthcare worker
- You are on, or about to start, treatment that suppresses your immune system
- You are HIV positive
- Tests show you may benefit from treatment
In general, you will not be offered treatment for latent TB if:
- You are 36 years old or older
- You are not HIV positive
- You have existing liver disease
The reason you may not be offered treatment is because there is a risk of liver damage from anti–TB drugs. However, if in these cases it is decided to offer you treatment you will be closely monitored.
Latent TB is treated with the same antibiotics used to treat active TB. Usually 6 months of a single antibiotic (isoniazid or rifampicin) or 3 months of combined treatment of both antibiotics is given.
Again it is important to complete the full course of your treatment. If you stop your treatment before the course is finished you may still have TB germs within your body. These germs could develop into active TB at some point in the future.
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Drug–resistant TB
Some people are initially infected with a 'drug–resistant' strain of TB. You can also develop drug–resistant TB because you fail to complete all of your treatment.
Unfortunately, infections with drug–resistant strains of TB are very hard to treat as the usual TB antibiotics will not work. So, although you may start to feel better 2 or 3 weeks after starting your treatment you must complete the whole course of treatment. This may take as long as a year in some cases.
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Overseeing your treatment
Help is available to ensure you complete your
full course of treatment. You will usually be
seen by a TB / respiratory nurse who will
oversee your treatment, offer advice and answer
any questions you may have.
You may need additional help to complete your TB treatment, e.g. if you find it difficult to take your drugs regularly. This support is available through a programme called Directly Observed Treatment (DOT). DOT can be very successful and is used throughout the world as part of controlling modern–day TB.
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Side effects
TB treatment involves taking several drugs every day for at least 6 months. Like all treatments some of the drugs may cause side effects for some people.
If you notice any of the following side effects you should speak to your TB / respiratory nurse, or doctor, as soon as you can. You may be able to take an alternative antibiotic.
- Problems with your eyes, e.g. blurred vision or loss of vision
- Feeling sick, stomach upsets
- Dizziness
- Rash and / or itchy skin
- Pins and needles or 'tingling feeling' in arms
and / or legs - Effects on your liver, e.g. jaundice (yellow tinge to skin and eyes), malaise and weakness, confusion / irritability, swollen tummy, lack of appetite
Rifampicin can make your body secretions (e.g. urine, tears) a reddish orange colour. This is normal and nothing to worry about. If you wear soft contact lenses they may also change colour.
Rifampicin also interacts with a wide variety of drugs, in particular all forms of hormonal contraception. Therefore, you must use another form of contraception during your treatment for TB if this applies to you. Also, if you take drugs to control epilepsy you may need to alter your dose. You must tell your doctor / nurse about any other drugs you are taking, including any vitamins or supplements.
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