Your doctor will keep a close eye on your TB once you start receiving treatment to make sure that the tuberculosis treatment is working and that you’re no longer able to pass the disease on to anyone else. Doctors will look for physical signs that you’re improving and that the active tuberculosis disease is being destroyed. Tests will also be done to look for signs that your body is responding to tuberculosis treatment. “A number of measures are monitored to determine response to treatment. These can broadly be divided into clinical and microbiological markers,” says George Smulian, MD, associate director of the division of infectious diseases at the University of Cincinnati. Physical Signs That TB Treatment Is Working Physical signs of tuberculosis treatment success include:
A reduction in symptoms, such as less coughingOverall improvement in the way one feelsWeight gainIncreased appetiteImprovement in strength and stamina
Testing to Monitor Tuberculosis Treatment Lab tests are performed during tuberculosis treatment to determine if any TB bacteria are left in your body. Sputum tests, which examine the thick mucous that is characteristic of TB, are typically done on people undergoing tuberculosis treatment for active pulmonary (lung) tuberculosis disease. Examining the sputum at regular intervals lets your doctor know the condition of your lungs — to confirm that the active tuberculosis disease is regressing and treatment is progressing the way that it should. “From a microbiological standpoint, it would be expected that one will get clearing of the Mycobacterium tuberculosis bacteria from the sputum, by staining and examination under a microscope, and also by culture [a lab procedure in a technician looks for growth of bacteria on a plate or in a tube],” says Dr. Smulian. “In most situations, sputum examinations are performed monthly until the patient produces two consecutive samples where they have cleared the mycobacteria.” However, even after there have been two consecutively clean samples — no tuberculosis bacteria are seen under the microscope and none grow when cultured — treatment still has to continue to make sure that any hidden bacteria don’t start thriving again. “Treatment is continued through to the end of the recommended course [usually 6 to 9 months],” says Smulian. Complications of Unsuccessful TB Treatment If tuberculosis treatment isn’t successful or isn’t followed for the full course, complications may occur. These could include:
Permanent damage to the lungsSpread to other organs and organ damageDevelopment of strains of TB bacteria that are resistant to typical drugsDeath
Side effects from the strong antibiotics prescribed to treat TB are also very common and need to be closely monitored, too. “Side effects from the medications vary depending on the drug used, but with most drugs, liver inflammation is the most common side effect,” Smulian says. “With some drugs, patients are monitored for other effects such as changes in vision and, rarely, kidney or nerve damage.” What’s most important is beating tuberculosis and completely destroying all the bacteria so they don’t come back. Your doctor will check you regularly to be sure that the rest of your health doesn’t suffer while you fight tuberculosis.
