Treatment

Treatment for TB has significantly reduced the mortality of the disease, which, in the preantibiotic era, was estimated at 50% within two years of diagnosis (3). Failures occur due to primary drug resistance or inappropriate drug regimen, but most commonly because of nonadherence to the long-term therapeutic regimen, because as patients feel better, their motivation to complete the long-term treatment course declines. Therefore, the responsibility of adherence has been transferred to the health system, and global efforts are under way to establish DOT as a means of monitoring a successful regimen.

The treatment strategies for TB are focused on the use of three or more active drugs; of these, INH and RMP are the most important; also included in the armamentarium are ethambutol, pyrazinamide, streptomycin, quinolones, and second-line agents. Selection of a drug regimen, monitoring and length of treatment, resistance testing, and other treatment issues should be addressed after consulting with a specialist and local public health authorities.

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