Treatment of Tuberculosis: (359142004-001)

Abstract

Even though children with tuberculosis (TB) tend to be noninfectious and not a risk to the community, they need to be treated. Proper treatment will cure them quickly. To prevent resistance, the anti-TB drugs (isoniazid, rifampicin, ethambutol, pyrazinamide, streptomycin, and thiacetazone) must be prescribed in an appropriate combination and in the right dosage, and they must be taken regularly under supervision and for a sufficient period of time. Treatment regimens with both isoniazid and rifampicin are the most effective regimens. Regimens can be shortened from 12-18 months to 6-8 months if they contain rifampicin. They are called short-course chemotherapy (SCC). SCC achieves higher completion rates and better cure rates than long-course chemotherapy. Health workers should abide by the national guidelines or, if there are no national guidelines, the World Health Organization's TB treatment guidelines. TB SCC begins with an initial intensive phase that lasts for a minimum of 2 months. It consists of a combination of at least 3 drugs to eliminate as many TB bacilli as possible and to prevent drug resistance. Fewer drugs are needed for the continuation phase that lasts for 4-6 months. Anti-TB drugs can be taken daily or 3 times a week. The final outcome of the intermittent therapy is the same as the daily therapy. Intermittent therapy is less suitable for young children. In children, the anti-TB regimen depends on pretreatment weight and is adjusted if necessary after 2 months. Health workers need to make sure that children with TB have no other infections. Malnutrition exacerbates the child's ability to fight infections. Young TB patients should be encouraged to eat. Adults are considered cured when their sputum smear changes from positive to negative; for children the best indications of a successful cure are completion of treatment, weight gain, and improvement in general health. Children rarely experience relapse and failure. Incorrect diagnosis or not taking the drugs usually accounts for failure. Sometimes drug resistant TB is responsible.