Multiple-Drug Therapy for Tuberculosis (TB)

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Multiple-Drug Therapy for Tuberculosis (TB)

Examples

First-choice medicines:

Brand NameGeneric Name
Myambutolethambutol
isoniazid 
pyrazinamide 
Mycobutinrifabutin
Rifadin, Rimactanerifampin
Priftinrifapentine

Second-choice medicines:

Brand NameGeneric Name
amikacin 
Capastat Sulfatecapreomycin
Seromycincycloserine
Trecatorethionamide
Levaquinlevofloxacin
Aveloxmoxifloxacin
Paserpara-aminosalicylic acid
streptomycin 

Combination medicines:

Brand NameGeneric Name
Rifaterisoniazid plus pyrazinamide plus rifampin
Rifamateisoniazid plus rifampin

How It Works

These antibiotics kill the bacteria that cause tuberculosis (TB).

Multiple-drug therapy to treat TB means taking several different antibiotics at the same time. This is the first choice of treatment for TB that is growing in your body (active TB disease). Most of these medicines are given as pills. The American Thoracic Society, Centers for Disease Control and Prevention, and the Infectious Diseases Society of America recommend using one of several combinations of the first-choice medicines to start treatment.1

The standard treatment is to take isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months. Treatment is then continued for at least 4 months with fewer medicines. Also, there are special treatment recommendations for people with HIV and TB, people with drug-resistant TB, children with active TB, and pregnant women with active TB.

Prepared combination medicines, such as Rifater, are usually used when there is a need for fewer numbers of pills, such as when a health professional is not giving each dose of medicine personally. Combining antibiotics into a single pill makes it less likely that you will miss taking any doses. Failure to take a medicine could prolong your treatment and increase your chance of developing drug-resistant TB.

Streptomycin usually is given only to people who cannot take ethambutol.

Isoniazid given alone usually prevents a latent TB infection from turning into active TB disease, which can spread to other people.2 Rifampin also can help prevent latent TB from becoming active TB.

Why It Is Used

Treatment with several medicines makes it more likely that all TB-causing bacteria will be killed. The combination of medicines and the length of treatment may change based on:

How Well It Works

Treatment for active TB disease

The standard treatment for TB using a combination of four medicines is very effective. Almost everyone infected with TB bacteria that can be killed by the medicines are cured if they take the medicines exactly as they should.3, 4 The cure rate for people who have TB and HIV is similar to that for people who have only TB.3

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