Tuberculosis Treatment System

Tuberculosis Treatment

Tuberculosis, commonly referred to as TB, is an infection that affects the lungs and may also affect bones, joints, the circulatory system and central nervous system. This disease can be highly contagious if left untreated. In 1993, the World Health Organization declared TB to be a world health emergency because of the frequency of infection and the ease in which it spreads. It is estimated that nine billion new cases are reported each year.

As with any disease, it is better to ensure prevention. TB vaccinations are common and highly effective, especially in children. TB vaccinations are very common in the United States as well as other countries. Although a higher percent of children are successfully protected, if adults have not received a TB vaccination it is recommended they get one.

Symptoms of TB include chest pain, coughing, inability to breathe and pneumonia-like symptoms. However, it is also common to be infected and show no outward signs. Diagnosis of the disease will occur with a complete examination including a TB skin test. It is important to minimize the damages by early detection and prompt treatment. This can mean the difference between full recovery and possible death.

Treatment of this disease can be complicated, especially if there are other factors such as HIV. It is recommended that quarantined hospitalization occur to monitor progress and reduce the risk of spreading. Common drug therapies include antibiotics specifically designed for TB treatment such as Isoniazid, Rifampin, Pyrazinamide, Streptomycin and Ethambutol. Unfortunately, there are many strains of tuberculosis that have become resistant to the medications. It is very important for continued monitoring to ensure effectiveness of a drug or combination of drugs.

In the instance where the body is resisting drugs, surgery may be necessary. The portion of the lungs affected may be removed. Also, chest tube drainage may be required. In these cases, recovery percentages are very low. In order to reduce this risk, treatment as early as possible is advised. Patients who have an early diagnosis or are not immune to the drug treatments have a high success rate of complete recovery. Relapses are extremely rare with proper treatment.

With over two billion people affected with tuberculosis in the world, the seriousness of this disease can not be denied. Prevention of the disease is the best way to keep the spreading of it in check. This includes ensuring children are properly vaccinated and all shots are kept up to date. Early detection and treatment are also key factors in guaranteeing complete recovery and minimizing risk of relapse.

Tuberculosis and Its Relationships with 2 Billion People

Tuberculosis, a bacterial infection, most commonly affects the lungs. Tuberculosis can also affect the central nervous system, lymphatic system, circulatory system, genitourinary system, bones and joints. Often Called TB for short, tuberculosis is the most common major infectious disease today. With that title the virus is infecting two billion people which is approximately one-third of the world's population. Nine million new cases of active disease annually, resulting in two million deaths. Most of these cases and deaths are in developing countries.

Ninenty percent of those that are infected have asymptomatic latent TB infection (LTBI). This is alot of numbers: There is a ten percent chance that in the lifetime of LTBI that it will progress to active TB disease. This active disease if left untreated, will kill more than fifty percent of its victims. All of these numbers make tuberculosis one of the top three infectious killing diseases in the world. HIV/AIDS kills 3 million people each year, TB kills 2 million, and malaria kills 1 million.

Tuberculosis is caused by a slow-growing aerobic bacterium that divides every 16 to 20 hours. This division is extremely slow when compared to other bacteria, which tend to have division times that are measured in minutes.

In many patients the infection of Tuberculosis waxes and wanes. Treatment with appropriate antibiotics kills bacteria and allows healing to take place. Areas where Tuberculosis has affected will eventually be replaced by scar tissue. A complete medical evaluation for Tuberculosis includes a medical history, a physical examination, a tuberculintut, a serological test, a chest X-ray, and microbiologic smears and cultures. This is quite an extensive procedure as you can see, but if you look at the numbers above it is a necessary process.

The Sanatoriums Method in Dealing Tuberculosis

The age of Tuberculosis sanatoria began in 1849 when public health tried to isolate the sick persons from the healthy population. The fact that Tuberculosis is actually a contagious disease and can be transmitted from man to man was not yet known.

The idea of Tuberculosis being a curable disease and not a death sentence was first expressed by doctor Brehmer in 1854 after he suffered from the disease himself. As a student he caught Tuberculosis and was sent by his doctor to change the climate and live a healthy life in the Himalaya Mountains. He returned home cured and wrote a debate about how Tuberculosis can be cured.

Brehmer built a sanatorium for his tuberculous patients where they could get dietary food, fresh air, sun shines and a high elevated life.

The Tuberculosis suffering Doctor Trudeau opened the most famous sanatorium in America, Saranac Lake, where he also conducted laboratory testing and investigation concerning the cure of Tuberculosis. Patients in his sanatorium were strictly supervised, had to stay in bed the whole first three months to rest, eat healthy and drink high amounts of milk. Trudeau continued Koch’s studies of identifying the structure and physiology of Mycobacterium in order to understand how it could be killed.

All sanatoriums burned and disposed all the objects of the new income as it was proven the bacteria can for a period of time survive inside the clothes tissues, until it found a new host.

The sanatorium cure spread into entire Europe and America; it provided a dual action against Tuberculosis. Isolation of active cases from the healthy population made it possible to control the spreading of the disease. Secondly, sanatoriums provided the patients with regulate, hospital medical care and a better social and cultural environment.

Frequently, people were brought and interned in sanatorium against their will. Many persons could not understand the benefic consequences of this kind of cure, or even felt depressed. In an age without any sort of chemical medication the self-control, autosuggestion and a good moral played a tremendous role in the healing process.

The era of sanatoriums was over when the first antibiotic against Tuberculosis was discovered. Streptomycin successfully treated the infection and enabled patients to be treated in hospitals or receive home treatment. In order to prevent the development of resistance to antibiotics, a combination of efficient drugs is used in the medication lasting normally at least 6 months, even a whole year.

Diagnose and Treatment of Tuberculosis

Tuberculosis is still a very common disease mostly encountered in low developed countries and areas. TBC localizes especially in the lungs but can also affect kidneys, bones or other tissues.

There are three main diagnosing methods regularly used in hospitals all over the world:

1. The first made in cases of suspicion is the skin testing at Tuberculin, a purified protein derivation that checks the exposure of the patient to the infection. Although he might not have developed the disease, the patient that had contact with the bacteria causing the infection has possibly developed a type of hypersensitivity. The PPD will be injected under the skin and verified after 48-72 hours to detect a possible enlarged papule. A positive result of the testing indicates the prime infection to Tuberculosis. This test is not 100% certain and cannot guide the doctor to a sure diagnose without other investigations.

2. The secondary investigation is the search for Mycobacterium Tuberculosis in the sputum or other organic fluids or tissues.

3. The third but most meaningful testing is the chest X-ray detecting any kind of pulmonary injuries assembling to the ones in Tuberculosis. These three methods must be connected with significant signs and symptoms for Tuberculosis.

After a certain positive diagnose has been established, the doctor must proceed by other kind of tests to find the best treatment and the most adequate drugs to treat Tuberculosis.

As Tuberculosis infection can be caused by different strains of the bacteria, more recent genetic research has improved the speed of diagnose by using the polymerize chain reaction (PCR). Through the strain multiplication of a microscopic bacterial fragment doctors obtain the genetic material required to establish the right treatment.

Prevention methods are also available in TBC cases. The BCG vaccination during childhood decreases the risk of Tuberculin infection at children. A good ventilation of the air in public places disperses the bacteria and reduces the risk of contact. Ultraviolet rays are most helpful in closed environments as they also kill Mycobacterium Tuberculosis, but they cannot guarantee the 100% certainty of prevention.

The basic treatment of Tuberculosis is a combination of more antibiotics found to be efficient against the particular type of bacterial strain. One single antibiotic is likely to lead to resistance developing. The cure must last for at least 6 months but the duration of treatment can go up to 9 months or a whole year. Most common, the combination of Hydrazid, Rifampicin, Pyrazinamid and Ethambutol is used in treating tuberculin infection.

Lately, the entire bacterial genome of Tuberculosis has been decoded. We expect new methods of prevention and treatment in the next following years.

A Short Introduction to the Anti Biotherapy in Tuberculosis

Although antibiotics had been discovered a few years before, sulfonamide and penicillin proved no effect on the bacteria causing Tuberculosis. After years of research In California about soil fungus, in 1039 Waksman isolated the fungus Actynomices that was able to inhibit the development of Mycobacterium Tuberculosis. But the chemo was to dangerous toxic and could not be used in treating Tuberculosis.

In 1943streptomycin was found inside Streptomyces griseus and it was proven to totally inhibit the bacterial strains. In 1944 it was administered to a Tuberculosis patient that immediately improved. Although streptomycin causes side effects like damages to the inner ear, it was for a few years the best medication against Mycobacterium.

The medical treatment of Tuberculosis was put in danger after the assumption that bacteria rapidly gains resistance even to the newer discovered antibiotics. But the issue was quickly solved by using combinations of antibiotics in the treatment.

After streptomycin other major anti Tuberculosis chemo were introduced. P-aminosalicilic acid, Isoniazid, Pyrazinamide, Ethambutol, Rifampicin and Cycloserin showed benefic results in the cure of Tuberculosis. Newer Aminiglicosides such as Viomycin and Kanamycin as well as the quinolones Ciprofloxacin and Ofloxacin are only prescribed in cases of resistant strains. Latest treatment methods like the Macrolides or the combination of Beta-lactamase and Beta-lactams have not been yet enough studied.

The two most important characteristics of the antituberculous ant biotherapy are:

1. The antibacterial activity best resulted in Streptomycin, Isoniazid and Rifampicin.

2. The inhibition of the development of resistance with best results in Rifampicin, Ethambutol and Izoniazid.

After a month of treatment with the four basic antibiotics, the patient should be fever free, feel much improved and show decreased number of bacteria in the sputum. The weight of the patient must increase and the lesions visible on the X-rays should minimize. As the medication persists the bacterial organism in the sputum will become more and more difficult to be cultivated on synthetic cultures inside the laboratories.

If no signs of improvement appear on the radiography after 3 months, the medication and the patient’s compliance must be again verified. Most relapses after treatment appear in the first 6 months after the patient has stopped taking chemo. Also the capacity of developing resistance must be taken into consideration. The National Tuberculosis Center must carefully monitories rebel cases of Tuberculosis.

In case of a reoccurrence at the same patient, doctors must find another schedule of therapy as the bacteria has already developed resistance to the antibiotics used before. A possibility is adding other few antibiotics to the initial medication. If bacteria is resistant to all kind of standard chemical products, other drugs, more toxic however will be put in the schedule: Ethionamide, Cycloserine, Viomycin, Kanamycin, Pyrazinamide or Capreomycin.

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