Evaluation and Treatment
Active TB Disease
Active TB disease means that TB germs are alive and “awake” in our body. If you have active TB disease, you have symptoms like a bad cough, night sweats, fatigue, and weight loss. Also, you can spread TB germs
How Do You Evaluate Persons Suspected of Having TB Disease?
A complete medical evaluation for TB includes the following:
1. Medical History
Clinicians should ask about the patient’s history of TB exposure, infection, or disease. It is also important to consider demographic factors (e.g., country of origin, age, ethnic or racial group, occupation) that may increase the patient’s risk for exposure to TB or to drug-resistant TB.
2. Physical Examination
A physical exam can provide valuable information about the patient’s overall condition and other factors that may affect how TB is treated, such as HIV infection or other illnesses.
3. Test for TB Infection
- Mantoux tuberculin skin test (TST) or
- TB blood test can be used to test for M. tuberculosis infection.·
4. Chest Radiograph
- A posterior-anterior chest radiograph is used to detect chest abnormalities.
5. Diagnostic Microbiology
- Sputum Sample
Treatment for TB Disease
TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens include:
- isoniazid (INH)
- rifampin (RIF)
- ethambutol (EMB)
- pyrazinamide (PZA)
Regimens for treating TB disease have an initial phase of 2 months, followed by a choice of several options for the continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment).
It is very important that people who have TB disease finish the medicine, taking the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat.