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Treating Drug-Resistant Tuberculosis

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People infected with tuberculosis (TB) bacteria that are antibiotic-resistant need special treatment programs. People with a weakened immune system are more likely to get drug-resistant TB. These include people infected with HIV or people who have had an organ transplant.

Treatment usually involves at least four medicines.1

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  • A treatment program using four to six medicines appears to be best. The choice of medicines depends on the results of sensitivity testing.
  • Most treatment programs involve isoniazid, rifampin, and pyrazinamide, along with one to three second-choice medicines.
  • Second-choice medicines used to treat drug-resistant TB usually have more side effects than the first-choice medicines. Second-choice medicines include streptomycin, capreomycin, ethionamide, kanamycin, ofloxacin, para-aminosalicylic acid, and rifabutin.
  • It is very important to take every dose of medicine. So directly observed therapy (DOT) usually is done. During DOT, a health professional watches you take every dose of medicine.
  • Treatment is continued until TB bacteria can no longer be found in two sputum samples taken a month apart. This may take 18 months or longer in people with multidrug-resistant TB (MDR-TB).

Some TB bacteria have become resistant to all of the antibiotics that are commonly used to treat TB. This is sometimes called totally resistant tuberculosis (TDR-TB).2 A TB infection of this type is very difficult to treat.

1

WebMD Medical Reference from Healthwise

Last Updated: November 14, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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