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What are the Elements of Tuberculosis Management?

By D. Jeffress
Updated May 17, 2024
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Tuberculosis is a potentially life-threatening complication of a severe bacterial infection. The disease was difficult to treat in the past, but modern medicine, new diagnostic techniques, and knowledge about contagious pathogens has helped doctors develop highly effective tuberculosis management plans. The elements of tuberculosis management in a hospital setting are fairly universal, though patients may need to receive different types of medications based on their specific symptoms. Most people with active infections are given four drugs on a regular schedule for up to one year. Health care workers make sure that patients take their medications on time and monitor changes in symptoms to develop an ongoing tuberculosis management plan.

Once a person is suspected to have active tuberculosis, he or she is usually admitted to the hospital and placed in a quarantined room. The bacteria responsible for infection are highly contagious, especially in a hospital setting where many people are already sick. Blood tests and diagnostic imaging scans can confirm infection. The patient is started on a course of four different drugs, isoniazid, pyrazinamide, rifampin, and ethambutol. Intravenous fluids also are provided to prevent dehydration, and other symptoms of shallow breathing, fever, or aches are treated accordingly.

Most cases of tuberculosis originate and remain in the lungs. Patients with pulmonary tuberculosis usually need to continue taking their medications for two weeks on a daily basis. After the two-week mark, an individual can usually reduce dosages to two or three times a week. Doctors carefully monitor medication use for at least the first month of treatment to make sure the drugs are effective and that negative side effects or reactions are kept to a minimum.

Patients who respond well to medical treatment may be taken off of pyrazinamide and ethambutol after two months. They continue to take the other two antibiotics for four to ten months, depending on symptoms and results from ongoing blood tests. It is important for a patient to stick with a prescribed tuberculosis management plan even if he or she starts feeling better to make sure all bacteria are gone. Tuberculosis can become latent in the body after a few months, but surviving pathogens can reactivate after a period of dormancy and cause recurring infection.

Additional drugs or clinical therapies may be needed in tuberculosis management if bacteria migrate from the lungs to the brain, heart, kidneys, or other organs. Patients might be prescribed drugs to stabilize blood pressure, treat or prevent kidney infection, and ease inflammation in the brain. Most cases of tuberculosis are responsive to ongoing treatment, and patients who are diagnosed in the early stages of disease have very good chances of making full recoveries.

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