How is tuberculosis treated?

A person with a positive skin test, a normal chest x-ray, and no symptoms most likely has only a few TB (tuberculosis) germs in an inactive state and is not contagious. However, the treatment to these cases is combated with antibiotics to prevent the TB from turning into an active infection. The antibiotic used for this purpose is called isoniazid (INH). If the person takes it for six to 12 months, it will prevent the TB from becoming active in the future. In contrast, with a person positive skin test that does not have to take INH, there is a 5%-10% lifelong risk that the TB will become active.
Taking isoniazid can be inadvisable (contraindicated) during pregnancy or for those suffering from alcoholism or liver disease. Also, isoniazid can have side effects. The side effects occur infrequently, but the patient can feel tired or irritable. Liver damage from isoniazid is a rare occurrence and typically reverses once the drug is stopped. It is important therefore, for the doctor to monitor a patient's liver by periodically ordering blood tests called "liver function tests" during the course of INH therapy. Another side effect of INH is a decreased sensation in the extremities referred to as a peripheral neuropathy. This can be avoided by taking vitamin B6 (pyridoxine), and this is often prescribed along with INH.
Active TB is treated with a combination of medications along with isoniazid. Rifampin (Rifadin), ethambutol (Myambutol), and pyrazinamide are the drugs commonly used to treat active TB in conjunction with isoniazid (INH). Four drugs are often taken for the first two months of therapy to help kill any potentially resistance of bacteria. Then the number is usually reduced to two drugs for the rest of the treatment based on drug sensitivity testing that is usually available by this time in the course. Streptomycin, a drug that is given by injection, is used particularly when the disease is extensive and/or the patients do not take their oral medications constantly.
Treatment usually can last for many months and sometimes for years. Successful treatment of TB is dependent largely on the obedience of the patient. In fact, the failure of a patient to take the medications is the most important cause of failure to cure the TB infection. In some locations, the health department demands direct monitoring of patient obedience with therapy.
Surgery on the lungs may be could help cure TB when medication has failed, but in this days, surgery for TB is unusual. Treatment with appropriate antibiotics will usually cure the TB. Without treatment, tuberculosis can be a lethal infection. Therefore, early diagnosis is important. Those individuals who have been exposed to a person with TB, or suspect that they have been, should be examined by a doctor for signs of TB and make TB skin tests.