Modern anti-TB drugs are designed to fight an infectious disease that affects a very large percentage of humanity. Pathology is due to the presence in the body of Koch's bacillus. Perhaps latent current and open type. Treatment should be combined. Usually a negative prognosis is inherent only in case of non-compliance with medical recommendations or the wrong selection of therapeutic measures. Modern combined anti-TB drugs are highly effective, therefore, they can improve the quality of human life and achieve complete cure.
Step by step
There are many options for treating tuberculosis. Therapy is divided into two stages: the main unit and supporting measures. First you need to destroy the colonies of the pathological microorganism and cope with the open form. A patient with this type of disease spreads mycobacteria around himself when he coughs and sneezes. As part of the main course, bacterial resistance to drugs must be prevented. Previously, a three-component course was used, but these days they rarely resort to it. The scheme using five drugs is shown.
What is this about?
If you ask a doctor about how TB is treated, the doctor will first mention Isioniazide. It is a pharmaceutical product in tablet form designed to treat mycobacterium infections. It is well tolerated, side effects usually occur only at the beginning of the treatment course. To minimize them, the patient is prescribed vitamin complexes enriched with components of group B.
No less useful are Rifampicin, Ethambutol and Pyrazinamide. Finally, “Streptomycin” is prescribed. In renal failure, this effective tool is prohibited.
Ethionamide
Talking about how to treat tuberculosis, the doctor will definitely pay attention to this popular remedy. Belongs to the category of synthetic and to some extent similar in structure to isoniazid. This compound is the active ingredient in the Ethide and Reginicide preparations. It is known for its effectiveness in infection with isoniazid-resistant strains. Studies have shown a bacteriostatic effect in relation to life-forms capable of multiplying. It is equally shown for the localization of the pathogen inside the cell, and outside it. In the focus of inflammation, under the influence of a medication, phagocyte activity can increase.
The drug is prescribed to combat both typical and atypical pathogens. The substance is rapidly absorbed during the passage of the gastrointestinal tract, distributed throughout organic tissues. Ethionamide is able to penetrate the blood-brain barrier, in the body cavity, foci in capsules. The transformation process takes place in the liver, excretion is carried out with urine. The half-life reaches three hours, becomes longer with kidney failure.
Pronicide
The main active ingredient of the drug is protionamide. The substance is dangerous for the liver and can cause hepatitis, although this phenomenon is rarely diagnosed. The risk of this consequence is higher if the patient consumes rifampicin or has previously been ill with hepatic pathologies.
"Pronicide" is prescribed to persons over 14 years of age. The dosage inside is calculated on the basis of weight. For a day - no more than 20 mg / kg. The maximum volume for a day is one gram. The drug is used either at a time, or divided into several portions - up to three. Talking about how and with what tuberculosis is treated, the doctor will pay attention to the need for the most careful use of the drug. You should first prescribe the patient a minimum amount of medication, gradually increasing the amount. In general, the medication is slightly better tolerated than ethionamide. However, it has practically no other differences. Some forms of mycobacteria are cross-resistant: to ethionamide and protionamide at the same time.
"Cycloserine"
As can be learned from the instructions for use, Cycloserine is one of the natural, natural antimicrobial compounds. It was first used in medical practice to fight tuberculosis in the middle of the last century. Modern pharmaceutical manufacturers make this drug synthetically. Concentration determines the effect of the drug. A bacteriostatic effect is possible, a bactericidal effect can be achieved.
The drug shows a good result when infected with typical forms. Multiresistant strains do not show associated drug resistance. The instructions for the use of "Cycloserine" indicate the effectiveness of this tool when infected with a number of positive and negative microorganisms according to the Gram study. In the framework of the issue under consideration, this has no clinical significance.
Technical points
"Cycloserine" when it enters the human body is well absorbed during the passage of the gastrointestinal tract. Bioavailability reaches 90%. The substance penetrates the blood-brain barrier and is able to seep into most organic fluids, tissues, where it accumulates in a therapeutically effective amount. The ability to pass through the placental barrier, excreted in breast milk was revealed. The active ingredient of the drug is partially metabolized. Excretion is carried out by the renal system. About two-thirds of the dose taken is displayed in active form. The half-life reaches ten hours and increases with kidney failure.
Approximately every third patient, forced to take "Cycloserine", is faced with the neurotoxicity of this drug. Possible mental disorders, loss of orientation and suicidal tendency. Some during treatment are easily irritated, become aggressive. Hallucinations are possible. Others have a sore head and are spinning, are drawn to sleep, speech is disturbed. To minimize such phenomena, it is necessary to use "Cycloserine" in the amount of grams per day or less, and also regularly check the content of the substance in the circulatory system.
When and how much?
As a drug for tuberculosis, Cycloserine has been used for a long time. More often it is prescribed as a backup element of a multicomponent chemotherapy course. Assign if resistance to first-line anti-TB drugs is detected or the patient’s body can hardly tolerate them.
A small therapeutic range is noted. It is important to regularly check blood serum levels if kidney function is impaired.
Adults "Cycloserine" is assigned a two-week course. A single dose - a quarter of a gram, pauses between applications - 12 hours. After a two-week program, treatment is continued twice a day using the drug. The daily volume is calculated as 10 mg / kg or twice as much. Children are shown to use "Cycloserine" twice a day at the rate of 10-20 mg / kg. You can not eat more than a gram per day.
Kapastat
Like many other antibiotics indicated for tuberculosis , this one has established itself as a reliable bacteriostatic effect. The structure is a polypeptide. Natural remedy. Side effects triggered by his administration, similar to initiated aminoglycosides. The substance shows a pronounced effect in a typical course. Mycobacteria can be resistant simultaneously to the active component of this drug (capreomycin) and kanamycin. Cross-resistance with amikacin is less often observed. This effect does not occur simultaneously with streptomycin resistance.
Capreomycin is poorly absorbed during the passage of the gastrointestinal tract, on the basis of which it is released for intravenous administration. Not able to penetrate into brain tissue, not subject to transformation, eliminated in active form with urine. The elimination half-life is estimated at an average of five hours, increases to four days with poor renal functionality.
Features of the reception
Kapastat is toxic to the kidneys and auditory system. May cause muscle, nervous blockade. In the area of ​​administration, it is disturbing with pain. There is a chance of local bleeding and the formation of an infiltrated area. There is a danger of a sterile abscess.
With tuberculosis, the drug is prescribed as a reserve element of the course. Used if first-line drugs do not show the desired effect or are poorly tolerated by patients.
Intramuscularly, patients of any age are prescribed once a day. A single dose cannot be more than a gram. The daily volume is calculated as 15-30 microns / kg.
Mycobutin
This semi-synthetic preparation is made using rifabutin, which belongs to the rifampicin class. It has an extensive range of efficiencies. The structure and a number of qualities are close to rifampicin. The use of this tool as the only component of treatment soon leads to the formation of resistance in the pathological microorganism.
Used in the treatment of persons over 14 years of age. The recommended dosage of an anti-TB drug for adults varies between 0.15-0.6 g at a time. In the case of an atypical course, the dose should be at least 0.45 g. As a prophylactic, daily use of 0.3 g of the drug is prescribed. It is allowed to prescribe the drug in atypical form and in case of resistance of the strain to rifampicin.
Technical aspects
The substance is well absorbed during the passage of the gastrointestinal tract. Bioavailability reaches 100%. The active ingredient is able to penetrate various tissues. Transformation processes are localized in the liver. Excreted in various fluids: urine, bile, saliva, tears. The elimination half-life reaches 45 hours. Not corrected by renal activity.
Ciprofloxacin
As you can learn from the instructions for use, "Ciprofloxacin" (500 mg - one of the forms of release) is a reliable antibiotic from the category of fluoroquinolones. The drug was developed by the Bayer pharmaceutical company. Information about it was first published in 1982. Low toxicity of the active component is noted. Regarding the causative agent of tuberculosis, it shows moderate effectiveness.
Instructions for use "Ciprofloxacin" 500 mg talks about the bactericidal effect of the use of the drug. This is observed in the case of the latent period, and with the growth of the microbial cell. The substance belongs to the class of inhibitory DNA gyrase. Persistence is possible with a mutation of the microorganism. The drug activates humoral immunity and to a moderate degree corrects phagocytosis.
About combinations
In case of tuberculosis, WHO recommends combination drugs. In our country, such use is quite limited. These medicines give the best result if a person is afraid of medicines and negatively treats them, does not trust doctors.
Often use a combination composition in which there is isoniazid and rifampicin. The components in one capsule are present in an amount of 0.1 + 0.15 g or 0.15 + 0.3 g. The combined agent is prescribed in a program lasting 6-8 weeks. On sale, the drug is presented under the names "Rifanag", "Rifamat", "Tibinex".
About folk remedies
If you ask a healer what to treat the disease, propolis may be advised. With tuberculosis, this substance allows you to increase the body's ability to defend itself from pathological microflora. The most popular option is tincture. Cooking begins with cooling propolis in the refrigerator. Due to the cold, the structure will become fragile, it is easier to work with such a substance. It is crushed, wrapped in canvas and poured with alcohol. The dose is calculated as follows: 100 ml per 10 g. The components are mixed in a darkened glass dish and insisted for 1-1.5 weeks, mixing several times daily. Then for another day left to stand in the refrigerator and decanted the liquid. The drug is eaten an hour before the meal, breeding 20 drops in a glass of warm milk. The duration of therapy reaches 9 months. Every two months, a two-week pause is required.