Call your doctor if you develop any of the symptoms of TB [
Table 1]. Early case recognition and early prevention will increase the likelihood that treatment will be effective, and will reduce the risk of damage to the lungs or other areas in the body.
It is very important to follow your doctor's treatment plan closely in order to prevent the disease from worsening. TB treatment will be ineffective unless you adhere strictly to your drug regimen. Regularly missing drug doses can allow the bacteria that cause TB to recover or become resistant to treatment.
Reduce or eliminate alcohol intake while taking antituberculosis drugs (especially isoniazid). Alcohol use puts you at risk for serious liver-related side effects from these drugs.
Your doctor is the best source of information on the drug treatment choices available to you.
Surgery is sometimes necessary to drain pus from wherever it has accumulated, or to correct a bone deformity that has resulted from the infection. In extreme and rare cases (generally in cases where the patient has failed to follow the drug treatment plan), surgery is required to remove a portion of the lung.
Patients are usually cured if they follow an effective drug regimen very closely. Without proper treatment, however, more than half of TB patients will die within five years. Drug-resistant strains of TB are becoming more common in certain parts of the world. Being infected with drug-resistant TB can lead to serious infection and death. The severity of active TB depends on several factors, including a person's age, and the presence or absence of other complications such as coexisting disease or a weakened immune system.
Once a healthy adult's immune system has controlled a primary TB infection, the dormant bacteria will usually live in their lungs for life without causing disease unless the infection is reactivated.
Your doctor should evaluate your progress monthly after discharge to make sure that your treatment is working. Call your doctor immediately if you experience recurring symptoms of TB. Directly observed therapy may be required if complications arise. In directly observed therapy, which is endorsed by the World Health Organization, healthcare workers observe patients take every round of medication for the entire treatment course to ensure compliance.
If you experience any adverse drug reactions, you must contact your physician immediately and undergo further testing. Patients taking isoniazid, rifampin, or pyrazinamide may experience liver complications. Report to your doctor immediately if you experience nausea, loss of appetite, dark urine, malaise, or unexplained fever. In addition, patients taking ethambutol should be alert for any changes or problems in their vision.
Chest x-rays can be done periodically during therapy, and after therapy is complete, in order to monitor recovery. X-rays are helpful for tracking the progress of recovery; however, changes in the lungs may lag behind bacteriologic response, and therefore may not be absolutely accurate.
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