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Is outpatient treatment possible for tuberculosis? Chemotherapy of pulmonary tuberculosis in inpatient and outpatient settings

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Hello Anna Sergeevna!

1 day - isoniazid (1 tablet)

Now the questions:

I'm looking forward to the answers!

12.08.2011, 21:33

Hello.

Thank you, i.e.

Advantages and disadvantages of outpatient treatment for tuberculosis

Do you need to add streptomycin to isoniazid and rifampicin during these 4 months of support, in what dose?

13.08.2011, 14:45

Got it, thanks!

17.08.2011, 23:21

18.10.2011, 17:43

Thank you!

Anna Sergeevna, greetings.

Good afternoon

I would like to get some advice on whether it is possible to fast after an illness?

23.02.2012, 11:16

Got it, thanks!

Outpatient treatment

Outpatient treatment is one of the important stages of long-term chemotherapy for tuberculosis patients. For a significant proportion of patients, outpatient treatment is a continuation of treatment begun in the hospital; for another, less significant proportion, treatment is carried out entirely on an outpatient basis.

Outpatient treatment of patients should be carried out according to a strictly individual plan, taking into account pathological changes in organs and clinical manifestations tuberculosis in every patient.

How to behave during the outpatient stage of tuberculosis treatment?

The basic principles of antibacterial treatment remain valid for outpatient treatment. During outpatient treatment, correct and systematic monitoring of drug intake is necessary. The forms and methods of control are different: taking the drug in the presence nurse, for which the patient comes to the dispensary, or laboratory monitoring of taking drugs from the GINK and PAS group.

For laboratory monitoring of patients taking GINK drugs, the following method is used: to 5 ml of urine, 5 ml of a reagent is added, which includes ammonium vanadium - 0.1 g, glacial acetic acid - 5 ml, concentrated sulfuric acid - 2.2 ml, distilled water - 100 ml. If GINK drugs are present in the urine, a brown color appears.

To determine PAS in urine, the following method is used: add 5-10 drops of urine and 3-5 drops of a 3% ferric chloride solution to 5 ml of distilled water.

If the patient's urine contains PAS, the solution turns red-violet.

The introduction into practice of a single dose of tuberculostatic drugs, as well as various intermittent chemotherapy regimens, greatly facilitates the organization of controlled outpatient treatment of tuberculosis patients.

Both of these methods (one-time and intermittent) were introduced into practice after experimental and clinical observations and are used in both outpatient and inpatient settings. It has been proven that with a single daily dose of tuberculostatic drugs, a sufficiently high concentration of drugs is created in the blood of the patient being treated to obtain a therapeutic effect.

A justified and correct method of treatment is a one-time dose for patients after several months of divided doses of drugs, necessary to relieve severe intoxication and radiologically determined favorable evolution of the tuberculosis process. Thus, after 2-4 months of intensive chemotherapy in a hospital (or sanatorium), you can switch to the method of taking a single daily dose medicines.

Discussion Club of the Russian Medical Server > Medical consultation forums > Infectious diseases > Tuberculosis > Diagnosis and treatment of tuberculosis > I am being treated for tuberculosis on an outpatient basis.

Hello Anna Sergeevna!
I came across this forum by accident and I really liked the content and professionalism of your answers.
I also suffer from tuberculosis and am always trying to find out the effectiveness of the actions and prescriptions that TB doctors give me, but I always come across irritation and such a reaction - mind your own business, don’t pretend to be smart, drink what they give you, but All side effects Someday they will pass... But we all want to be healed completely and do it with the least harm to the body!!!
My diagnosis: infiltrative tuberculosis the upper lobe of the right lung, VK-, was identified for the first time, as in the majority, by accident. Weight 55 kg. height 162 cm.
I am undergoing outpatient treatment. I have already completed an intensive course, but not very cleanly, because after 1.5 months of taking chemotherapy drugs (isoniazid-1 tablet, rifampicin-4 tablets, pyrazinomide-4 tablets, ethambutol-3 tablets) I began to have a severe allergy with hives and itching on the arms and legs, but the phthisiatrician forbade reducing or canceling doses, because Resistance may develop, but he prescribed Suprastin 2 tablets. per day. After 3-4 days I could no longer sleep due to itching and hives all over my body.

Is it possible to treat tuberculosis on an outpatient basis?

After that, I was taken off the medications for 3 days and detoxified with prednisone during this time. How this affected drug resistance is not clear, no one has explained...
Then they prescribed me to take medications according to the following scheme:
1 day - isoniazid (1 tablet)
Day 2 – isoniazid + rifampicin (1+4)
Day 3 – isoniazid + rifampicin (1+4)
Day 4 - isoniazid + rifampicin + pyrazinamide (1+4+4)
Day 5 - isoniazid + rifampicin + pyrazinamide + ethambutol (1 + 4 + 4 + 3)
After the 4th dose, my allergy appeared again and I was left to drink only isoniazid + rifampicin (1+4) until the end of the intensive course.
I passed the interim tests and took an overview picture, they said the tests were normal, the picture shows positive dynamics.
Now the questions:
1. tests showed high hemoglobin - 158, sugar -5.7 and ketones++ in the urine (liver tests are all at the upper limit of normal, other indicators of the blood flow and blood volume are normal), but the phthisiatrician said that this is normal, nothing needs to be done . Is this true?
2. I am transferred to a maintenance course: 3 times a week isoniazid + rifampicin (2+4), please advise, should I insist on taking isoniazid + rifampicin (1+4) daily, so the treatment will be more effective?
3. Is it possible to do gymnastics according to Strelnikova during the treatment period?
I'm looking forward to the answers!

12.08.2011, 21:33

Hello.
This is a typical pyrazinamide allergy. It can be replaced with streptomycin for 60 doses.
Hemoglobin is normal, as is sugar. But all together can indicate dehydration. Drink more.
WHO currently does not recommend intermittent dosing
You can do any gymnastics that does not lead to loss of consciousness.

And regarding resistance, can 3 days of interruption of dosage and then taking the drugs separately provoke resistance?

13.08.2011, 14:45

No, this should have been done in the intensive phase.
Stability could not provoke all this. Moreover, it was initially unknown about it.

Got it, thanks!
I have another question: is it possible to carry out cosmetic procedures such as injections of Dysport (Botox) and hyaluronic acid during anti-tuberculosis treatment?

17.08.2011, 23:21

It’s not worth it, the issue has not been studied, the consequences may be unpredictable.

Dear Anna Sergeevna! I need your advice again.
After two months of a maintenance course (daily intake), I took liver tests and they showed - ALT-86.4, AST-14.5, bilirubin-1.1. The phthisiatrician said that the tests were elevated and recommended taking Hepadif. And I already constantly take hepatoprotectors (Essentiale, Karsil, Hepabene) in courses of 20 days, brew oats with immortelle, corn silk and parmelia. I still have two more months of treatment, is it possible to switch to a 3-times-a-week medication regimen?

18.10.2011, 17:43

An increase in transaminases by less than 5 times does not require discontinuation of medications. Drink the so-called Hepatoprotector courses do not make sense.

Thank you!
That is, during treatment the liver and kidneys cannot be supported by anything?

Anna Sergeevna, greetings.

I would like to get some advice on whether it is possible to fast after an illness?
The treatment ended at the end of December 2011, I feel fine.

Good afternoon

I would like to get some advice on whether it is possible to fast after an illness?
Anti-tuberculosis treatment ended at the end of December 2011, I feel fine, general tests normal.

23.02.2012, 11:16

Hello. If you tolerate it well, it’s possible, but without violence to the body.

Got it, thanks!

View full version: I am being treated for tuberculosis on an outpatient basis.

Hello Anna Sergeevna!
I came across this forum by accident and I really liked the content and professionalism of your answers.
I also suffer from tuberculosis and I always try to find out the effectiveness of the actions and prescriptions that TB doctors give me, but I always come across irritation and such a reaction - mind your own business, don’t pretend to be smart, drink what they give you, but all side effects will go away someday... But we all want to be cured completely and do it with the least harm to the body!!!
My diagnosis: infiltrative tuberculosis of the upper lobe of the right lung, VK-, was discovered for the first time, like in most cases, by accident. Weight 55 kg. height 162 cm.
I am undergoing outpatient treatment. I have already completed an intensive course, but not very cleanly, because after 1.5 months of taking chemotherapy drugs (isoniazid-1 tablet, rifampicin-4 tablets, pyrazinomide-4 tablets, ethambutol-3 tablets) I began to have a severe allergy with hives and itching on the arms and legs, but the phthisiatrician forbade reducing or canceling doses, because Resistance may develop, but he prescribed Suprastin 2 tablets. per day. After 3-4 days I could no longer sleep due to itching and hives all over my body. After that, I was taken off the drugs for 3 days and detoxified with prednisone during this time. How this affected drug resistance is not clear, no one has explained...
Then they prescribed me to take medications according to the following scheme:
1 day - isoniazid (1 tablet)
Day 2 – isoniazid + rifampicin (1+4)
Day 3 – isoniazid + rifampicin (1+4)
Day 4 - isoniazid + rifampicin + pyrazinamide (1+4+4)
Day 5 - isoniazid + rifampicin + pyrazinamide + ethambutol (1 + 4 + 4 + 3)
After the 4th dose, my allergy appeared again and I was left to drink only isoniazid + rifampicin (1+4) until the end of the intensive course.
I passed the interim tests and took an overview picture, they said the tests were normal, the picture shows positive dynamics.
Now the questions:
1. tests showed high hemoglobin - 158, sugar -5.7 and ketones++ in the urine (liver tests are all at the upper limit of normal, other indicators of the blood flow and blood volume are normal), but the phthisiatrician said that this is normal, nothing needs to be done . Is this true?
2. I am transferred to a maintenance course: 3 times a week isoniazid + rifampicin (2+4), please advise, should I insist on taking isoniazid + rifampicin (1+4) daily, so the treatment will be more effective?
3. Is it possible to do gymnastics according to Strelnikova during the treatment period?
I'm looking forward to the answers!

12.08.2011, 21:33

Hello.
This is a typical pyrazinamide allergy. It can be replaced with streptomycin for 60 doses.

Treatment of tuberculosis at home - with great care

Hemoglobin is normal, as is sugar. But all together can indicate dehydration. Drink more.
WHO currently does not recommend intermittent dosing
You can do any gymnastics that does not lead to loss of consciousness.

Thank you, i.e. Do you need to add streptomycin to isoniazid and rifampicin during these 4 months of support, in what dose?
And regarding resistance, can 3 days of interruption of dosage and then taking the drugs separately provoke resistance?

13.08.2011, 14:45

No, this should have been done in the intensive phase.
Stability could not provoke all this. Moreover, it was initially unknown about it.

Got it, thanks!
I have another question: is it possible to carry out cosmetic procedures such as injections of Dysport (Botox) and hyaluronic acid during anti-tuberculosis treatment?

17.08.2011, 23:21

It’s not worth it, the issue has not been studied, the consequences may be unpredictable.

18.10.2011, 17:43

An increase in transaminases by less than 5 times does not require discontinuation of medications. Drink the so-called Hepatoprotector courses do not make sense.

Thank you!
That is, during treatment the liver and kidneys cannot be supported by anything?

Anna Sergeevna, greetings.

I would like to get some advice on whether it is possible to fast after an illness?
The treatment ended at the end of December 2011, I feel fine.

Good afternoon

I would like to get some advice on whether it is possible to fast after an illness?
Anti-tuberculosis treatment ended at the end of December 2011, I feel fine, general tests are normal.

Please clarify the situation. At the beginning of 2016, I found out that I was sick with HIV, at that time there were 32 cd4 cells, the internal lymph nodes were enlarged and on the left side the subclavian lymph node was inflated like a tennis ball. I was prescribed an anti-HIV drug and sent to the cancer center with suspected lymphoma. All this time the temperature remained from 37 to 40 and rose. Now it is also holding on, for almost a year already 37, in the evening until August 37. At the oncology center they took a biopsy (they removed the lymph node), found giant single cells of the Piragov type. This was in February 2016. They sent me to a phthisiatrician, to which the answer was given that this was possibly a consequence of HIV, since tuberculosis did not manifest itself anywhere else, neither in urine nor in sputum, the Diaskin test was negative. In November of this year, 2 more lymph nodes enlarged on the right side of my neck. I went to the phthisiatrician again, the Diaskin test and sputum were negative, I was sent to have my glasses reviewed district hospital, they said that it is typical for tuberculosis. With this conclusion, I was admitted to the hospital. In the hospital they gave first-line drugs tubazid, linamide, ethambutol, sparflo and an injection of amicocin. I asked to be treated on an outpatient basis, since the conditions in the hospital are terrible, the patients smoke, the stench in the room is terrible and there are many drug addicts. The doctor transferred me to outpatient treatment, where they told me that they didn’t have all the medications and that I would have to buy them myself; they didn’t give me amicocin; they replaced sparflo with levoflaxocin. Question: can treatment be done on an outpatient basis or is an inpatient facility required for the first 3 months? And is it possible to stop taking amicocin? Also, was it correct to replace Sparflo with levofloxacin?
And how can I further determine drug resistance if tuberculosis was not found in me anywhere except by histology?

New questions for the TB specialist:

22.02.2020
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Anti-tuberculosis dispensaries in the Russian Federation and the CIS

Donetsk Regional Clinical Tuberculosis Institution Kostanay KSU "Kostanay Regional Uralsk State Institution" Regional Anti-TB Karaganda KSE "Regional Anti-TB

Treatment of tuberculosis on an outpatient basis is one of the options for eliminating the consequences of exposure to mycobacteria, as well as preventing infection of surrounding people. To understand the effectiveness of such therapy, you need to have a general understanding of the disease, as well as the nuances of taking measures to eliminate the disease at home.

Tuberculosis is an infectious disease that is caused by various strains of Mycobacterium tuberculosis. The main route of transmission is airborne droplets. Also, Koch bacilli can enter the human body through contact with animals or through open wounds. After this, the pathogen promotes the formation of specific foci of inflammation, which cause the development of intoxication processes.

In the early stages, the disease does not manifest itself. Over time, the patient develops a number of clinical signs characteristic of infection with mycobacteria.

These include:

dry cough that lasts more than two weeks;
prolonged increase in temperature up to 38 degrees Celsius;
weight loss, loss of appetite;
increased sweating at night;
paleness of the skin, deterioration of general condition;
fatigue;
increase in the size of lymph nodes.

Tuberculosis is a primary disease. In the absence of timely treatment, the pathogen penetrates other organs, infecting them and activating the development of inflammatory processes.

Availability running forms disease contributes to the development severe complications, among which the most dangerous are:

acute respiratory failure;
impairment of kidney and liver function;
problems with the cardiovascular system;
lesions of the musculoskeletal system.

A few decades ago, it was generally accepted that tuberculosis was a disease of socially disadvantaged sections of the population. Today, no one is protected from infection with mycobacteria.

If you detect any symptoms of the disease, you should immediately seek advice from a phthisiatrician. He will help identify dangerous pathologies and prescribe appropriate therapy that will prevent the development of dangerous complications.

Most people who have been infected with mycobacteria are interested in the question: is it possible to treat tuberculosis on an outpatient basis? More recently, patients with this pathology were placed in special dispensaries, where they underwent a long course of complex therapy. Today, patients with a latent, unstable form of the disease have the right to undergo outpatient treatment with the consent of the attending physician.

Such patients need to regularly visit a tuberculosis clinic for diagnostic examinations and treatment procedures. At the same time, the phthisiatrician will be able to assess the dynamics of the disease and the effectiveness of treatment, as well as, if necessary, adjust it.

Outpatient treatment, like inpatient therapy, must be carried out comprehensively and contain certain components.

These include:

taking medications prescribed by the attending physician;
passing necessary procedures in a dispensary under the supervision of medical personnel;
performing physical therapy exercises;
proper nutrition;
compliance healthy image life.

Reviews from TB specialists whose patients received outpatient treatment indicate that recovery was faster and the number of complications was significantly lower. The main factor in this is the prevention of cross-infection with chemoresistant strains of mycobacteria.

Calm home environment has a positive effect on the emotional state of the patient undergoing anti-tuberculosis therapy.

The disease can be successfully cured with timely detection and appropriate therapy. It must be carried out comprehensively, using medications, medical procedures, special diet, as well as other methods. Self-medication is dangerous to the patient's health and can lead to adverse consequences.

Successful outpatient treatment consists of performing three main tasks that are established after the results of anti-tuberculosis diagnostics.

These include:

Neutralization of mycobacteria that have entered the body.
Elimination and prevention negative consequences effects of Koch's rods.
Restoring the previous state of health.

Therapy for the disease consists of two stages. First, an intensive phase is used, in which the patient receives the required amount of anti-TB drugs, and also frequently visits the attending physician to assess the effectiveness of the prescribed drugs. Then comes a period of prolonged treatment, during which the number of prescribed medications is reduced, and the patient can spend more time at home.

Drug therapy for tuberculosis consists of using drugs that most effectively eliminate the effects of Koch bacilli.

For this, first-line drugs are used, including:

Rifampicin;
Isoniazid;
Ethambutol;
Streptomycin.

If there is drug resistance to them, the phthisiatrician prescribes second-line drugs. They are less effective, but correct dosages and compliance with the regularity of their intake makes this drawback insignificant.

If a child has developed a tuberculosis infection, the doctor must draw up an individual course of treatment. At the same time, he takes into account the characteristics of his body, the degree of development of the disease and the presence of concomitant pathologies or complications.

It is better to start therapy for patients with tuberculosis in a hospital setting. This will allow the TB specialist to track the effectiveness of the drugs and procedures used.

Means traditional medicine can also be used to treat the disease at home. To do this, you need to consult with your treating specialist and get his approval. Unauthorized use of any tinctures or powders can aggravate the situation and harm the patient's health.

Before the discovery of antibiotics, people used folk remedies, the effectiveness of which was confirmed by the experience of many generations.

Among them it is worth highlighting:

Dried mole cricket powder.
Alcohol extract from wax moth larvae.
Baked milk with bear fat.
Oat bran decoction.
Natural honey with walnuts.

Treatment for pulmonary tuberculosis on an outpatient basis is impossible when the patient requires surgical intervention. This is necessary if the patient has severe forms of the disease, which are characterized by destructive lesions of the respiratory system.

There are several options for operations:

Removal of part of the lung or resection. In this case, excision of damaged tissue occurs with further elimination of the resulting defects.
Artificial pneumothorax. This intervention is performed in a hospital setting as a routine procedure. The patient is injected into the chest cavity with gas, which promotes the dispersion of mycobacteria, reduces the degree of intoxication and the density of decay.
Artificial pneumoperitoneum. The operation consists of temporary correction of the organ after resection.

Outpatient treatment of pulmonary tuberculosis cannot be done without a special diet, which helps speed up the regeneration processes and prevents the development of complications.

The patient's diet should include:

fresh vegetables and fruits;
river fish;
pureed porridges and soups;
lean meats;
homemade milk;
compotes and decoctions;
black bread.

When treating pulmonary tuberculosis in children and adults on an outpatient basis, nutrition should help strengthen the immune system and regenerate damaged organs. To do this, you need to increase the amount of calories consumed and also stop drinking alcoholic beverages.

Other diet principles during this period include:

Eating should be done every 3 hours in small portions.
Porridges, soups and purees should be ground.
The presence of allergies to any food products should be accompanied by limiting the amount of fast carbohydrates in the diet.

You should also avoid hot seasonings, vinegar, horseradish, mustard, fatty and fried foods. Dishes should be at a comfortable temperature for the patient and be freshly prepared.

With successful treatment of resistant tuberculosis on an outpatient basis, the doctor may prescribe a visit to sanatorium-resort places for consolidation. There the patient will be able to continue the second phase of therapy, as well as receive a positive effect from special procedures, a favorable climate and communication with people who have a similar problem.

You should not self-medicate, since incorrectly taken medications can lead to the development of drug resistance and cause complications.

Treatment various forms Tuberculosis treatment on an outpatient basis is a complex process, and in what cases it is effective - only a specialized specialist knows.

Disease prevention

Infection of a person with mycobacteria poses a danger to other citizens, since over time the disease can develop into active form followed by release of the pathogen into environment. To prevent this, there is a set of preventive measures that are used at the state level.

One of the main ways to prevent infection with Koch bacilli is to avoid contact with patients who have been diagnosed with tuberculosis. If people must interact with such patients, they need to use gauze dressings or respirators.

Also among the disease prevention measures it is worth highlighting:

Proper nutrition, with a sufficient amount of minerals and vitamins entering the body.
Strengthening the immune system.
Rational change of work and rest.
Quitting smoking and drinking alcoholic beverages.
Vaccination against tuberculosis, which can be done in any clinic.

Early detection of infection is highly treatable. In order to be able to detect the disease in a timely manner, children undergo a tuberculin test annually, and adults undergo fluorography.

If you have any specific symptoms and suspect infection with mycobacteria, you should not self-medicate by reading a special forum or taking advice from people you know. You should immediately consult a TB doctor. It will help solve the problem safely and prevent the development of dangerous complications.

Tuberculosis or consumption can creep up unnoticed and unexpectedly. Gone are the days when this infectious disease affected exclusively people leading an asocial lifestyle, eating poorly, and not taking care of their health. The danger of the disease is that the pathogen is present in the body of every person by the age of 30. Meanwhile, a mycobacterium that has once entered your body will wait for the moment to manifest itself. This situation can be caused by prolonged stress, poor nutrition, lack of physical activity in the fresh air. The disease, starting with a slight cough and malaise, which you, of course, attribute to stress and a slight cold against the background of fatigue and reduced immunity, can develop rapidly. Remember, tuberculosis is curable, but treatment for tuberculosis takes a long time, up to one and a half years, if the diagnosis is made late. How successfully tuberculosis is treated, how it is treated in modern conditions with new regimens and according to new principles is presented in this review.

Diagnosis of respiratory diseases is becoming the lot of doctors in multidisciplinary hospitals. Patients with tuberculosis must be treated by a phthisiatrician. If you, as a person who is conscious about your health, go to the clinic 1-2 times a year to receive consultations with doctors, then you will most likely be offered to go. Fluorography is also carried out as part of mandatory medical examinations and medical examinations.

Important! According to the results of fluorography, when patients apply to institutions of the general medical network at the place of residence, from 30 to 50% of cases of tuberculosis are detected in the early stages.

Thus, early identified symptoms are the key to a speedy recovery and the key to a favorable prognosis.

During illness, mycobacterium (the original infection) enters the body, forming the primary focus of inflammation. Strong immunity will not allow the inflammation to grow; it will be isolated in the tissue by a dense capsule. A weakened body is an ideal environment for the spread of tuberculosis infection. When the body's defenses decrease, the primary focus of inflammation is activated, and the infection spreads through the blood into the body's tissues. It is with the spread of infection throughout the body that weight loss is associated.

How does infection develop in the body?

Having penetrated the body with a current of air through the airborne route of infection (this happens most often), Mycobacterium tuberculosis will remain in the body for a long time and wait for the right moment to manifest itself.

Initial stage

Symptoms that indicate a person has initial stage tuberculosis:

Body temperature rises slightly; a person cannot always independently assess his slightly elevated temperature. Typically, when the infection spreads, the temperature is 37–37.5 degrees Celsius, and often rises in the evening.
The patient most often experiences increased sweating at night.
Sudden weight loss - up to 5-10 kilograms or more. The process of weight loss is associated with poisoning of the body and its need to get rid of mycobacteria.
A person feels loss of appetite, weakness, fatigue, and decreased performance.

If you have three or more of the listed points, you must urgently contact the nearest medical facility and have fluorography done.

Spread of tuberculosis throughout the body

A pathogen that is not identified in time contributes to the spread of infection in the body. At this stage, the disease becomes more obvious, the symptoms of tuberculosis make themselves felt, forcing the person to consult a doctor - chest pain appears, rejection of mucus with blood from the lungs - hemoptysis. Lymph nodes enlarge.

The lung tissue is gradually destroyed, which causes the separation of blood from the lungs. As a result of the destruction of lung tissue, cavities are formed - cavities, which are filled connective tissue, not responsible for oxygen exchange in the lungs.

The focus can be located in the lungs and pleura, that is, the respiratory organs; the symptoms of respiratory tuberculosis are respiratory diseases and respiratory failure. If the focus is outside the respiratory organs, then the symptoms will be intoxication and fever.

Chronic forms

Late detection of the disease often plays a role in the formation of the chronic form of the disease. In addition, the correct choice of treatment, the social and living conditions of the patient, the presence of bad habits, intolerance to certain medications. Even with timely appointment proper treatment, the factor of complete recovery largely depends on the resistant abilities of the body. How long tuberculosis is treated in each specific case will depend on the range of methods used, but on average the duration is up to 6 months.

How to completely cure tuberculosis

Tuberculosis, detected in a timely manner, can be treated well with modern medicine. The arsenal of antibiotics used can cope with any form of tuberculosis. Depending on the form of the disease, the patient is treated either on an outpatient basis - this is possible if the discharge of Koch’s bacilli is external environment does not occur and the sputum test for BK is negative. In the open form, treatment is carried out in a hospital - a tuberculosis dispensary.

The disease can be cured with an integrated approach to treatment. It is important to remember that only a TB doctor should diagnose pulmonary tuberculosis and prescribe treatment. The main methods of treating tuberculosis that are used in our country are medication and surgery. Pulmonary tuberculosis is treated at all stages of the disease.

Principles of treatment of pulmonary tuberculosis in adults and children

Treatment of tuberculosis in children, as well as in adults, is carried out in stationary conditions in TB medical institutions. The most important component of the treatment of tuberculosis in children is careful monitoring during the procedure and the appointment of a more gentle regimen. Tuberculosis in children and adolescents is cured on average within 2 months. Preferred in the treatment of pulmonary tuberculosis in children and adolescents are:

Simultaneous use of no more than two drugs in minimal dosages;
Carrying out procedures that strengthen the body - exercise therapy, massage, physiotherapy aimed at the chest;
Strengthening the patient's immunity.

The recovery time for the body after an infection in children is generally shorter than in adults. With the correct diet and the presence of strengthening factors for the body, the child’s body is completely restored in 4–12 months and the symptoms of the disease disappear. It is important during this period to form a special resistance of the body to mycobacteria that cause the disease.

Treatment in hospital

Important! To cure tuberculosis completely, you must follow the doctor's instructions. Strictly follow the treatment regimen, observe the dosage and frequency of medications, since antibiotics only work if taken regularly.

Most in an efficient way Tuberculosis treatment remains in the hospital. Now there are modern methods treatment of this infectious disease. The main advantages of treating tuberculosis in a hospital include: isolation of the patient from possible sources of infection and worsening the situation, constant monitoring of the condition and adjustment, control over compliance with medications.

The treatment regimen for tuberculosis includes chemotherapy, surgical interventions, pathogenetic treatment and collapse therapy.

Chemotherapy

The only option for a complete cure for tuberculosis in a hospital setting is chemotherapy. Along with chemotherapy, medications are prescribed that increase the effect on mycobacterial components.

The treatment regimen consists of the first (bacteriostatic and bactericidal) and second (sterilizing) stages. The medicine for tuberculosis, used in the first stage, allows you to get rid of most mycobacteria. At the second stage, pathogens that are in a latent, dormant state are destroyed.

Medicines

Important! To cure tuberculosis completely and not to lose, but to gain the body’s defenses, the correct treatment regimen is required, which is prescribed by a TB doctor. It should take into account the stage of tuberculosis, its localization, the duration of the process and the sensitivity of your particular pathogen to antibiotics.

Only the doctor decides how to treat tuberculosis, what treatment regimen to choose and how many days the treatment should last. As long as the mycobacterial component remains in the patient’s sputum, it is better for him to be in a hospital - an anti-tuberculosis dispensary, so as not to pose a threat of infection to others. Medicines for tuberculosis that most effectively cope with infectious pathogens are (R), (Z), (S) and (E).

After 20–25 days, the patient stops secreting infectious pathogens in his sputum - he is no longer infectious to others.

Tuberculosis is treated by a combination of chemotherapy and phthisiology methods, when organized proper nutrition, modes healthy sleep and rest.

Chemotherapy regimens for tuberculosis include stages where drugs are needed to treat tuberculosis, which lasts 2–3 months. After this, a period of stabilization begins. During this period, the patient continues to take the medications rifampicin and isoniazid, up to 4–6 months. This measure helps prevent the return of symptoms of the disease and the development of complications.

Throughout the treatment, total monitoring of the patient’s health status is carried out with the help of and. Antibiotics for pulmonary tuberculosis may stop helping, despite the efforts of phthisiatricians, if the disease becomes resistant to medicines form. To prevent the development of drug-resistant forms of tuberculosis, the World Health Organization updated recommendations on the use of antibiotics in 2017 and introduced new concepts of ACCESS, SUPERVISION and RESERVE.

Pathogenetic therapy

To cure tuberculosis completely and not to lose, but to gain the body’s defenses, the correct treatment regimen is required, which is prescribed by a TB doctor. It should take into account the stage of tuberculosis, its localization, the duration of the process and the sensitivity of your specific pathogen to antibiotics.

To restore the resources of the body, weakened by prolonged exposure to antibiotics and tuberculosis infection, drugs of the pathogenetic spectrum are prescribed. During the treatment process, the tissue regeneration processes of the respiratory organs are affected. Excluding pathogenetic treatment and limiting chemotherapy methods can lead to an imperfect type of healing of the affected tissues.

Pathogenetic drugs

Pathogenetic drugs include those used in complex treatment tuberculosis include:

Anti-inflammatory;
Non-steroidal drugs;
Steroid drugs;
Other drugs for tuberculosis with anti-inflammatory activity.

Patients are treated with a combination of methods aimed at increasing the body’s immune defense. This includes the prescription of a complex of immunomodulator drugs that affect T-lymphocytes.

Alternative Treatments

Next, we will try to answer the question of whether the so-called infection can be treated or not. People suffering infectious disease For many years, when it periodically makes itself felt, people wonder whether tuberculosis can be cured completely. Practice shows that the disease is curable with early diagnosis, chemotherapy and compliance with social and everyday recommendations.

There are several recommendations on how to treat pulmonary tuberculosis. Folk remedies cannot replace the prescription of a phthisiatrician, however, they remain a reliable aid in matters of additional symptomatic treatment of pulmonary tuberculosis and increasing immunity.

It is necessary to follow a daily routine - walk in the fresh air, drink boiled or sterilized milk and grape juice. To expectorate phlegm, it is good to use an infusion of marshmallow root and a decoction of coltsfoot leaves. Pour a tablespoon of dry raw material into a glass of boiling water and hold in a water bath for 15 minutes, take a third of a glass 3 times a day before meals. Ledum infusion (a tablespoon of raw material is infused in a glass of boiling water for an hour, consume 2 tablespoons 3 times a day before meals), a decoction of pine buds (pour 1 teaspoon of buds into a glass of boiling water and hold in a water bath for 15 minutes, leave for 1 -1.5 hours).

For tuberculosis, fish oil is also prescribed 3 times a day before meals, a teaspoon. Eating white cabbage is beneficial.

A popular cure for tuberculosis, which can be used in addition to the main therapy, is the use of honey with milk and other high-calorie foods with the addition of aloe juice.

Prevention of recurrence of the disease

Doctors recommend that people who have been ill and recovered, as well as when the process is chronic, spend time in the fresh air, preferably breathing sea air. No wonder Anton Pavlovich Chekhov, suffering from consumption, moved from Taganrog to Yalta by the sea to improve his health. recommended as a preventive measure for relapse of the disease. For example, in Crimea there are unique natural conditions of increased oxygenation (high oxygen content in the air), which prevent the spread of mycobacteria and also give new strength to the body to fight infection. Don't forget that proper balanced nutrition also cures tuberculosis patients, as does fresh air.

It is important to remember that tuberculosis can be completely cured and modern medicine has a comprehensive set of methods for completely curing the disease.

At the same time, the danger of the disease lies in its relapses. The absence of recurrent symptoms of the disease can only be guaranteed by regular care of your health.

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Pulmonary tuberculosis is considered a serious disorder of human health that requires close attention from doctors and timely treatment. The malaise develops against the background of the penetration of the microbacterial Koch bacillus into the body.

Outpatient treatment involves regular visit hospitals in order to receive medications and procedures necessary for health.
Such an event as outpatient in adults and in is a rather lengthy process that requires the patient to strictly adhere to medical recommendations. Elimination requires an integrated approach:

Reception special;

regularly undergoing research;

compliance with the appropriate regime.

In most cases, medication treatment is continued for one and a half to two years. Observation of the patient in a dispensary is considered the most preferable. The possibility of outpatient treatment of illness is determined solely by the doctor.

When is outpatient treatment possible?

The possibility of outpatient treatment of pulmonary tuberculosis depends on the current state of health of the patient. The doctor allows this form of recovery provided that the disease is identified early stage and the absence of a threat to others. Outpatient observation involves regular visits to a specialist to monitor health status, with extensive research.

Outpatient recovery involves:
Complex use of special-purpose medications.

Regular medical examinations.

Completion of a course of physiotherapeutic measures.

In most cases, the patient is transferred to outpatient treatment after observation in a hospital and undergoing an extensive course of therapy in a tuberculosis clinic. After the procedures, the patient does not pose a danger to others and continues to lead his usual lifestyle.

To maintain normal health, the patient must:

Visit the outpatient department daily to take the necessary medications under the supervision of specialists;

Regularly take the necessary tests and undergo other types of body tests.

In addition to radiography, the patient is prescribed fluorography and an immunology test.

Noticing the first signs of problems in your work respiratory system, you need to see a doctor immediately. This will allow you to exclude tuberculosis as the most serious form of pathology or begin a course of treatment in a timely manner. If the outbreak of infection takes on a significant scale, then outpatient observation is abandoned in favor of inpatient observation.

Chemotherapy for pulmonary tuberculosis

Often, treatment of pulmonary tuberculosis in adults on an outpatient basis does not show high effectiveness without timely chemotherapy. This form of influence on the patient’s body requires taking into account many factors.

The patient undergoes the same procedures as during inpatient treatment.

When determining the sufficient intensity of chemotherapy, specialists focus on the severity of the ongoing infectious process, the presence of bacteriological secretions, general condition the patient's immune system.

Anti-tuberculosis therapy has two main goals:
Active suppression of bacteria reproducing in the body;

Prevention of the proliferation of pathogenic flora.

Chemotherapy consists of several stages. At the first stage, the patient is prescribed four basic anti-tuberculosis drugs in order to identify a possible carrier of the infection. The time period for intensive chemotherapy is limited to 2 months. If, after this time, bacterial discharge does not disappear, a specialist examines the smears for 3 months. Maintaining certain time intervals between collecting material for research.

After moving to the second stage of chemotherapy, the patient begins taking two basic chemotherapy drugs for four months. Medicines must be taken daily without violating the regimen.

Cannot act as an alternative drug treatment. On an outpatient basis, refusal of special medications in favor of folk remedies treatment is unacceptable, as it can lead to disastrous consequences.

If during the initial examination the patient is found to have mycobacteria in any quantity, then chemotherapy is carried out using five main drugs. The same is done when a relapse of pulmonary tuberculosis is detected. If mycobacteria are not detected, then you can limit yourself to taking three basic anti-tuberculosis drugs.

For patients who have been diagnosed chronic form tuberculosis, the course of treatment is carried out according to an individual scheme. Having assessed the characteristics of the infectious agent, the phthisiatrician sometimes prescribes a single drug.

When the infection is actively spreading, chemotherapy is considered an integral and important part of the treatment of tuberculosis. Therapy involves continuous monitoring of the activity of infectious agents by a doctor. This is important because anti-tuberculosis drugs do not always destroy Koch's bacillus.

Features of physiotherapy

Physiotherapy allows you to achieve excellent results in getting rid of pulmonary tuberculosis. The technique is based on the impact of physical factors on the patient’s body: magnetic field, electric currents, laser beams, ultrasonic waves, IR and UV radiation, polarized light.

Physiotherapy helps achieve the desired effect as quickly as possible. Most of the methods of influence are practiced when the intoxication of the body has already been eliminated. The first method of physiotherapy for tuberculosis, prescribed earlier than others, is considered to be aerosol antibacterial therapy.

Methods of influence in individually selected by the attending physician. It takes into account the current state of the patient’s body, assesses the level of his immune defense and the prospects for the prescribed therapy.

In most cases, physiotherapy involves parallel treatment with several methods to achieve the best result.

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