Drug treatment of TB disease

drug treatment of TB disease involves several medicines

You don’t need to worry, TB can be treated and cured with medication, with rare exceptions. It is, however, necessary that you take drugs exactly as instructed by your doctor or nurse.

The TB bacterium is slow-growing and some of the TB bacteria can remain in an undivided state for a long time. Antibiotics are most effective against dividing bacteria. In addition, there may be a few among the large number of TB bacteria that are not affected by some of the drugs.

Therefore, treatment is started by giving several different drugs at the same time. This is a better way of killing all TB bacteria and preventing them from becoming drug-resistant.

The most common drugs used to treat TB are

  • rifampicin
  • isoniazid
  • pyrazinamide
  • ethambutol

TB drugs

It takes a long time to destroy all the TB bacteria.TB drug treatment takes at least six months, often longer. Usually four different drugs are given during the first two months, after which treatment continues with two drugs.

You will usually feel better after a few weeks of treatment. However, there are still live TB bacteria in your body. Even if you no longer have symptoms, it is important to keep taking the medicines until all the bacteria have been eliminated.

Drug treatment for TB is started in the hospital. Your doctor is responsible for the individual planning of the treatment, the choice and dosage of medications and the length of treatment. You can ask your doctor about specific details of your treatment.

Directly observed treatment

TB medication is given under observation.

Treatment observation is called DOT (directly observed treatment). In some cases treatment can also be observed via video. This is called video observed treatment (VOT).  This is implemented so that the patient records themselves ingesting the medications using a smartphone and sends the clips to the nurse for viewing.

You are entitled to support and guidance from staff throughout your treatment. Due to the length of your treatment and the large amount of medications, it can be challenging to take TB drugs regularly every day. The aim of treatment observation is to help you to take medications regularly and to help you get well as soon as possible.

Medication is taken in such a way that a nurse or other qualified worker observes you swallowing every dosage. At the same time, they will monitor adverse effects of the medication as well as your condition, and answer questions you may have. For young children, parents can give medication under the supervision of a professional.

The doctor in charge of the treatment decides when treatment observation is begun, modified, and when it can be finished. In the hospital a nurse will observe you taking your medications. Before you go home, it will be agreed upon how you will receive your medications after you leave the hospital. Taking medication can happen in the outpatient department of the hospital, in a health station, in an occupational health station, at school or for asylum seekers, at the reception center. If your condition requires it, a nurse can supervise treatment in your home or in some other place where you live. Treatment will be given under observation five to seven days a week depending on your situation. The way observed treatment is organized varies by municipality.

Interruption of TB medication on your own or not taking some of the medications every now and then can be dangerous. TB bacteria will multiply and your illness will last longer. TB bacteria can also become resistant to the drugs you are being treated with. You may have to take new medications, if the previous ones are no longer effective. New medications need to be taken for a much longer time and they will usually cause more adverse effects.

  • TB bacteria can only be eliminated by taking TB medications regularly
  • TB will be cured if you take medications as instructed
  • do not change or interrupt treatment
  • continue taking medications even if you feel better
  • drug treatment removes the risk of transmission

Treatment monitoring

Your recovery will be carefully monitored in the hospital outpatient clinic every 1-2 months during your treatment. Follow-up visits usually include a chest X-ray, blood tests and a sputum sample. You will also have the opportunity to ask the doctor questions.