Treatment of patients with tuberculosis

The main method of treatment is chemotherapy. Modern anti-tuberculosis drugs successfully operate both in the initial and in the prevalent forms of tuberculosis, providing a lasting cure for the vast majority of patients.
Given the effectiveness of all antibacterial drugs are divided into three groups.
The first group includes the most effective: isoniazid and rifampicin, the second group consists of medications of average efficiency: ethambutol, streptomycin, protionamide, pyrazinamide, cycloserine, kanamycin, viomycin. The third group includes PASC and tibon - preparations of moderate effectiveness. Treatment should be comprehensive, lengthy, continuous, stage-by-stage. Complex treatment provides for the simultaneous administration of two to four chemotherapeutic agents to influence bacteria with different sensitivity to medicines and to prevent drug resistance in mycobacteria.
The duration of the main course of treatment for the first time is 9-12 months (in the early stages of tuberculosis can be reduced to 6-9 months). Continuity of chemotherapy during the main course of treatment is necessary to suppress the ability of mycobacteria to reproduce. The main course of chemotherapy can be divided into two stages: intensive treatment in a hospital with a view to quickly eliminate acute manifestations of diseases and treatment in a sanatorium, then outpatient. For each patient, depending on the clinical manifestation and prevalence of the process, a suitable treatment regimen is selected. It can be changed if drug resistance is found in mycobacteria to a particular drug or the adverse reactions of the body are not eliminated.
In addition, to accelerate the reverse development of inflammation, i.e. Its suppression, the complex of treatment includes agents that stimulate immunity (levamisole, etizol, methyluracil, etc.); Prevention of the development of connective tissue, i.e. Sclerosing in the process area (pyrogenal, lidase, prednisolone, tuberculin), increasing the tissue resistance to injury, the so-called. Antioxidants (tocopherol, sodium thiosulfate). Widespread use in the treatment of tuberculosis is also antiallergic drugs, vitamins and other symptomatic remedies: antipyretic, expectorant, means for improving the functions of the cardiovascular system, hemostatic agents and others, oxygen therapy.
With pleural effusion, if the rates of resorption are slowed, removal of the liquid is indicated. With purulent tuberculous pleurisy, systematic removal of pus from the pleural cavity with simultaneous washing and the introduction of drugs.
An intermediate place between therapeutic and surgical methods of treatment is the so-called collapse therapy: the introduction of air into the pleural cavity (artificial pneumothorax) and into the abdominal cavity (pneumoperitoneum). Collapse therapy is used to treat patients with severe ipfiltrativnymi changes in the lungs and decay cavities, with pulmonary hemoptysis and bleeding, with drug resistance of mycobacteria.
Surgical methods for treating tuberculosis are used in a limited way, which is explained by the inability to promptly remove all foci. Surgical intervention usually with fibrous-cavernous pulmonary tuberculosis, less often - with tuberculosis. In children, isolated and multiple caseous-necrotic hilar lymph nodes are removed. For the treatment of patients with extrapulmonary localization, tuberculosis is used to economically resect the affected organ, remove caverns and sequesters (dead bone tissue). Carry out also bone-plastic operations.
The first task is to protect the healthy from the infection. Sputum should be carefully collected in special spittoons and disinfected. Disinfectant solutions are also soaked underwear, which was used by the patient. Spittoons can be boiled together with phlegm. The patient who secrets the sticks must be separated from the healthy ones (a separate room, a bed behind the screen, his own dishes, a towel, handkerchiefs, etc.).
The patient should rinse his mouth, often wash his hands, use spittoons for sputum. In the dust can be tubercle bacilli. The sun's rays kill them, so light, fresh air and cleanliness are necessary measures against tuberculosis infection.
Great preventive work is performed by tuberculosis clinics, which monitor the patient's living conditions and conduct sanitary and educational work among the population.
A healthy, strong organism is less susceptible to disease, so hardening of the body, exercise, cold wiping, a healthy lifestyle protect against tuberculosis.
Vaccination and revaccination is carried out for all children at high risk: in contact with patients with active tuberculosis and living in rural areas, an unsuccessful tuberculosis of cattle.