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CDST_LT: General concepts in TB treatment

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  • First line anti TB drugs

    Content

    First line drugs are the least toxic and most effective drugs that are used in first line of therapy.

     

    The first-line antituberculosis drugs that form the core of treatment regimens are

     

    Drugs

    Characteristics

    Rifampicin (R)

    Helps in early clearance of tuberculosis bacteria from the specimen

    Isoniazid (H)

    Most Powerful drug, that destroys all population of tuberculosis organism

    Pyrazinamide (Z)

    Kills or stops the growth of certain populations of TB bacilli

    Ethambutol (E)

    Prevents the growth of TB bacilli in association with other tuberculosis drugs to prevent emergence of resistant bacilli

     

    Resources:

    • Tuberculosis: Multidrug-resistant tuberculosis (MDR-TB)

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  • TB Drug Regimen

    Content

    A regimen means a prescribed systematic form of treatment for a course of drug(s). For TB treatment, Multi drug combination of regimen is followed. 

     

    All TB drug regimens have an initial intensive phase(IP) followed by a continuation phase(CP). 

    Following are some of the main TB drug regimens used based on the drug resistance pattern detected for TB patients.

     

    • First-Line Anti TB Drugs(Prescribed for Drug Sensitive TB DS-TB)
      • Daily weight band wise FDC

     

    • Second-Line Anti TB Drugs (Prescribed for Drug Resistance TB - DR-TB)
      • H Mono Poly Regimen
      • Shorter oral Bedaquiline containing MDR-TB regimen
      • Longer oral Bedaquiline containing regimen
      • Shorter injectable containing MDR-TB regimen
  • Treatment Phases

    Content

    Standard TB Treatment is divided into two phases

    • Intensive Phase(IP): In this phase,
      • Kills most of the TB bacteria during the first 8 weeks of treatment, but some bacteria can survive longer
      • Therefore, more drugs are administered to kill the bacteria and reduce the severity of disease.
      • Treatment in this phase usually is of short duration(2 to 6 Months or more) in comparison to Continuation Phase(CP)

     

    • Continuation Phase(CP): In this phase,
      • All the remaining TB bacteria are in the dormant stage i.e., stage when growth and development of bacteria are temporarily stopped.
      • Therefore, fewer but powerful antibiotics are administered to kill those bacteria. 
      • Treatment in this phase usually lasts longer than Intensive Phase(IP)(4 to 18 Months or more)

     

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  • FDCs used in NTEP

    Content
    Image
    FDCs used in NTEP
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