Interprofessional care
- Hospitalization not necessary for most patients
- Infectious for first 2 weeks after starting treatment if sputum +
- Drug therapy used to prevent or treat active disease
- Need to monitor compliance
Drug therapy
- Active disease
- Treatment is aggressive
- Two phases of treatment
- Initial (8 weeks)
- Continuation (18 weeks)
- Four-drug regimen
- Isoniazid
- Rifampin (Rifadin)
- Pyrazinamide
- Ethambutol
- Patients should be taught about side effects and when to seek medical attention
- Liver function should be monitored
- Alternatives are available for those who develop a toxic reaction to primary drugs
- Directly observed therapy (DOT)
- Noncompliance is major factor in multidrug resistance and treatment failures
- Requires watching patient swallow drugs
- Preferred strategy to ensure adherence
- May be administered by public health nurses at clinic site
- Latent TB infection
- Usually treated with Isoniazid for 6 to 9 months
- HIV patients should take Isoniazid for 9 months
- Alternative 3-month regimen of Isoniazid and rifapentine OR 4 months of rifampin
- Vaccine
- Bacille-Calmette-Guérin (BCG) vaccine to prevent TB is currently in use in many parts of world
- In United States, not recommended except for very select individuals
- Can result in positive PPD reaction
