TB treatment: what you need to know right now

Tuberculosis (TB) is treatable, but the plan depends on whether it’s active or latent, and whether the bacteria are drug‑resistant. If you or someone close to you has a positive test, this page explains the usual drugs, how long treatment lasts, common side effects, and practical steps to finish therapy safely.

How TB is treated: the basics

For active pulmonary TB, doctors usually start a combination of first‑line antibiotics to avoid resistance. The common drugs are isoniazid, rifampicin (rifampin), pyrazinamide, and ethambutol. Treatment normally begins with a 2‑month intensive phase using several drugs, followed by a continuation phase of fewer drugs for at least 4 more months. That means most courses last six months, but some cases require longer.

Latent TB infection (positive skin or blood test without symptoms) often gets a shorter preventive course so bacteria don’t become active later. Options include several months of isoniazid alone, rifampicin alone, or a combined shorter regimen. Your doctor will pick what fits your health, age, and other medicines.

Drug‑resistant TB and special situations

When TB resists isoniazid and rifampicin (called MDR‑TB), treatment gets longer and uses second‑line drugs such as certain fluoroquinolones, linezolid, or newer drugs like bedaquiline under specialist care. MDR and extensively drug‑resistant TB need close monitoring for side effects and adherence because treatment can last many months to years.

If you have HIV, liver disease, diabetes, are pregnant, or take other medicines, your TB drugs need careful choice and monitoring. Rifampicin interacts with many drugs — it can lower the effect of hormonal birth control, some HIV meds, and certain blood thinners. Tell your provider all medications and supplements you use.

Directly Observed Therapy (DOT) is common: a nurse or trained worker watches you take pills to ensure the whole course is finished. Completing treatment is essential — stopping early can cause relapse and resistant TB.

Watch for side effects. Common issues include nausea, loss of appetite, fatigue, and numbness (often from isoniazid). Some drugs can hurt the liver, so blood tests are routine early and during treatment. Avoid alcohol while on TB meds, and report jaundice, dark urine, severe stomach pain, or unusual bleeding right away.

How TB is diagnosed matters for treatment. Doctors combine symptoms, chest X‑rays, sputum smear or culture, and molecular tests like GeneXpert to confirm TB and detect resistance quickly. That helps pick the right drugs fast.

Practical tips: take meds at the same time each day, keep a pill box or calendar, join a support program if offered, and don’t skip clinic visits. If you’re a close contact of someone with TB, ask about testing and preventive treatment.

If you suspect TB or have test results, see a healthcare provider experienced with TB. Proper diagnosis and a full, supervised treatment plan give you the best chance of cure and reduce the risk of spreading TB to others.