Treatment Line, To Control And Cure TB

Tuberculosis or TB or TB is claimed to be the 3rd deadliest infectious disease according to WHO. In 2020, it is reported that 10 million people suffer from TB worldwide, including 5.6 million men, 3.3 million women, and 1.1 million children. Even though it is contagious and deadly, it turns out that TB can be prevented and cured, with treatment.

Did you know that TB treatment has categories or lines?

Category 1 or first-line treatment, usually given to patients with active pulmonary TB. In the initial phase (intensive phase), Anti-TB drugs (OAT) were given every day for 2 months, in the form of a combination of isoniazid, rifampin, pyrazinamide, and ethambutol. While the advanced stage, OAT is given every day for 4 months, in the form of isoniazid and rifampin. In first-line treatment, doctors usually also prescribe Vitamin B6.

Category 2 or second-line treatment, given to patients with resistant pulmonary TB. Drug resistance is caused by tuberculosis bacteria that are resistant to at least one first-line drug regimen of tuberculosis, usually referred to as multidrug-resistant TB (MDR-TB), or cases of TB that are resistant to >1 anti-TB drugs, which include isoniazid and rifampin. Isoniazid-resistant pulmonary tuberculosis can be treated with rifampin, pyrazinamide, and ethambutol for 6 months. Therapy may be extended to 9 months if sputum cultures remain positive after 2 months. Pulmonary TB that is resistant to rifampin can be given isoniazid, fluroquinolones, and ethambutol for 12-18 months, accompanied by pyrazinamide for the first 2 months. Pulmonary TB that is resistant to rifampin can be given isoniazid, fluroquinolones, and ethambutol for 12-18 months, accompanied by pyrazinamide for the first 2 months.

Drug-resistant TB patients also have to repeat the TB treatment phase from the beginning so that the total requires a longer period, which is at least 8-12 months, possibly up to 24 months. Side effects of treatment can be more severe. Therefore, patients are expected to take medication regularly and not to stop before taking medication so that drug resistance does not occur and treatment can be faster.