Tuberculosis (TB) is one of the most common infections in the world. According to the World Health Organization, in 2022 about 10 million people were infected with TB and 1.3 million people died from the disease. In Canada, there are about 1,800 new cases of TB every year.
The bacterium that causes TB is called Mycobacterium tuberculosis. Someone can become infected and yet not have any symptoms of the active disease – this is called inactive TB.
For someone with a healthy immune system, there’s a 10% lifetime chance of the TB bacteria reactivating and causing the active symptoms of TB. If the immune system has been weakened because of HIV (human immunodeficiency virus) or other illnesses, the risk of moving from an inactive infection to an active symptomatic disease is higher.
Babies, preschool children, and seniors are also at greater risk of reactivation due to weaker immune systems.
Only people who have active TB infections can spread the TB bacteria. Coughing, sneezing, even talking can release the bacteria into the surrounding air, and people breathing this air can then become infected. This is more likely to happen if you’re living in close quarters with someone who has TB or if a room isn’t well ventilated.
Once a person is infected, the bacteria will settle in the air sacs and passages of the lungs and, in most cases, will be contained by the immune system.
Your chances of becoming infected are higher if you come from – or travel to – certain countries where TB is common. People who are at greater risk for TB infection include the elderly, homeless people, people with substance use problems, individuals who have spent time in a correctional facility, and people with weakened immune systems from HIV or AIDS (acquired immune deficiency syndrome). Of course, the odds increase if you have close or frequent contact with someone who has active TB symptoms. This is especially true for health care workers who may be exposed to patients with active TB.
The following factors may play a role in promoting active disease in someone who has an inactive TB infection:
Antibiotics are used to treat TB, since it’s a bacterial infection. You may be hospitalized or told to avoid contact with other people until tests show that you’re not contagious.
For TB lung infections, 3 or 4 antibiotics are combined for the first 2 months of therapy. 2 or 3 of these are then taken for another 4 to 7 months, depending on the number and type of antibiotics used as well as the sensitivity pattern of the TB bacteria that were cultured from the individual.
The antibiotics most commonly used include isoniazid, rifampin, pyrazinamide, and ethambutol. Most people will take medications every day for the first 2 months, then several times a week or daily for the remaining treatment. It’s important to take your medication as instructed by your doctor, and for the full course of the treatment. This helps to ward off types of TB bacteria that are antibiotic-resistant, which take longer and are more difficult to treat.
If a particular type of TB infection is resistant to regular antibiotic treatment, a combination of different medications must be taken for up to 24 months.
Once symptoms clear up, a doctor may re-test your sputum to see if the TB bacteria are still present. If you have a TB infection in other parts of your body (e.g., bones or joints), you may require treatment for more than 1 year. If you are taking isoniazid, your doctor may suggest that you take 50 mg of pyridoxine (vitamin B6) daily to prevent a side effect called peripheral neuropathy.
To prevent spreading TB, it’s important to get treatment quickly and to follow it through to completion. This can stop transmission of the bacteria and the appearance of antibiotic-resistant strains.
A vaccine is available to limit the spread of bacteria after TB infection. The vaccine is generally used in countries or communities where the risk of TB infection is greater than 0.1% each year. It is used in newborns in these communities to prevent TB and its complications in the first few years of life. In Canada, this vaccine is not usually recommended. Research and development for a more effective vaccine is underway.
If a positive skin test is detected and other tests have confirmed that active TB is not present, your doctor may choose to prescribe a medication that prevents a TB infection from progressing to the active disease. The antibiotic regimens most commonly used include a combination of isoniazid and rifapentine, which is usually taken daily for 3 months, or rifampin taken daily for 4 months.
It is important to take your medications for as long as your doctor recommends. If you stop taking your medications before your doctor suggests, the TB infection can recur, you could get active TB, or the TB bacteria may become resistant to the medications you are taking.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2025. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Tuberculosis
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