Adherence counselling

Your guide to TB treatment

You have been diagnosed with TB. What’s next?

Being diagnosed with TB can be scary. We’re here to help make sense of it and stick to a treatment plan.

Beginning treatment for TB

Once diagnosed, your doctors/nurses/clinic sisters will explain the next steps. You’ll receive a treatment plan and specialised medication. Depending on how severe your status is, treatment can last between six to nine months. For Extensively Drug-Resistant TB (XDR-TB) that can extend to more than 18 months in total. XDR-TB treatment involves a different and much stronger dosage. This article provides an overview of a typical diagnosis and treatment plan in South Africa.

Trust your medical practitioners

Experienced medical staff at clinics and hospitals know what they’re talking about. Listen carefully to their explanations and ask them any questions that might appear in your mind while you’re with them. Make notes on exactly when you should be taking your medication (before or after meals); what substances to avoid and what other medication may cause negative reactions with your TB medication. You can further develop your understanding by asking what kinds of physical activity you should do more of or avoid during treatment.

Discipline has never been more important.

Ordinary TB can be quite severe, especially for people also coping with HIV. The bacteria can develop a mutation very quickly so taking medication at the right times every day for the full duration of the treatment plan is critical. If even a single dose is taken a few hours later than prescribed, it’s possible for the TB to mutate into XDR-TB, meaning any of the medication you continue to take will have no impact on treating the strain of TB evolving inside the body. It may become necessary to visit your medical practitioners again, and starting over with an XDR-TB treatment plan, which becomes even more important to follow. As long as you’re disciplined, you have nothing to worry about.

Never skip a dose, even if you feel better before the end of the designated timeline.

Even if you start feeling better, and you think you’ve sufficiently recovered, don’t ever stop taking your medication. Until your doctors confirm that you can stop your doses, your body is still fighting TB at a molecular level. Halting your medicine will result in the bacteria mutating, becoming XDR-TB and resisting your medication. Your condition could quickly degenerate to a state far worse than when you were first diagnosed. Overcoming XDR-TB means starting over again and being placed onto a much stronger, more extended treatment plan.

HIV/TB co-infection treatment plans

For people coping with HIV, being diagnosed with TB presents more danger than it does for HIV negative patients. A co-infection programme is prescribed, which combines antiretrovirals (ARVs) with antibiotics in very specific doses. This helps your body cope with and conquer both conditions simultaneously. Because every patient’s body is different, it’s most critical that you remain committed to treatment adherence in this situation. Don’t share medicine with anyone even if you know that they also have to cope with HIV and TB together. Sharing medication is extremely risky and can make both your conditions worse.

References:

Bronze, MS, and Herchline, TE. 2018. Tuberculosis (TB) treatment and management. Medscape. 1 October. Available at: https://emedicine.medscape.com/article/230802-treatment [Accessed 22 July 2019].

Centers for Disease Control and Prevention. 2016. Treatment for TB disease. 5 April. Available at: https://www.cdc.gov/tb/topic/treatment/tbdisease.htm [Accessed 22 July 2019].

TB Facts. 2019. TB treatment – TB drugs, failure, duration, relapse. Available at: https://www.tbfacts.org/tb-treatment/ [Accessed 22 July 2019].

United Kingdom National Health Service. 2016. Treatment – tuberculosis (TB). 15 November. Available at: https://www.nhs.uk/conditions/tuberculosis-tb/treatment/ [Accessed 22 July].

World Health Organisation. 2010. Treatment of Tuberculosis: Guidelines. 4th edition. Geneva: World Health Organization, cited in National Center for BioTechnology Information, n.d.. Available at: https://www.ncbi.nlm.nih.gov/books/NBK138748/ [Accessed 22 July 2019].

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