How do we Treat TB?
Treatment of LTBI can help prevent possible reactivation and progression to active TB. Doing so provides important individual and public health benefits – especially if given to people at high risk of developing active TB.
Active TB Treatment
There are three fundamental objectives of treatment of active TB:
1. Rapid killing of TB bacilli, to produce rapid improvement in the clinical condition of the patient and thereby prevent complications, prevent death and prevent transmission by reducing contagiousness.
2. Prevent the emergence or worsening of drug resistance.
3. Prevent the relapse of disease after completion of therapy and achieve long-lasting cure.
INH is used as a first-line treatment for TB and was first introduced in 1952. INH is effective at killing bacteria in the first few days. It comes in a pill form or syrup form.
PZA was discovered in the 1940s. PZA is beneficial in killing bacteria in the first two months of treatment. It comes in the form of pills. PZA does not cause side effects normally, however effects should be monitored carefully.
A rifamycin that acts similar to RMP and has fewer drug interactions. RBT is often used with HIV or transplant patients.
Second-line drugs and are alternative drugs for TB. There are ongoing trials to test the use of FQNs for TB.
Classified as a “first-line” treatment of TB in Canada. RMP is the most potent and has good bactericidal activity. RMP allows for a shorter treatment duration. RMP can be used for LTBI and active TB treatment. It is given in the form of oral pills.
Type of rifamycin, used in combination with other antibiotics. Has a half-life that is longer than RMP and can be given once a week. It is not recommended for active TB treatment and is only available through the Special Access Program in Canada.
Classified as a first-line treatment drug, it is effective for drug resistance prevention but lacks rapid bacteria killing activity. EMB is added during the Initial phase if drug resistance is suspected. It is given in combination with other first line drugs. Dosage is based on age, weight, condition and response to treatment.
Considered for second-line treatments. Amikacin is the only injectable that is approved in Canada and is mostly avaialble in hospitals.
How do we Prevent TB in Canada?
Currently in Canada there are several approaches to TB prevention, while there isn’t a singular national initiative, there are prevention initiatives in various regions and provinces/territories:
- LTBI treatment programs to prevent progression to active TB
- Screening in high risk settings and populations
- Inter-jurisdictional TB groups with stakeholders, communities, and health authorities
Canadian TB Strategies
British Columbia Provicinal TB Strategy
Alberta Provicinal TB Strategy
Saskatchewan Provicinal TB Strategy
Manitoba: Provicinal TB Strategy
Ontario Provicinal TB Strategy
Quebec Provicinal TB Strategy
New Brunswick: Fact Sheet
Prince Edward Island; Provicinal TB Strategy
Nova Scotia: Provicinal TB Strategy
Newfoundland and Labrador Provincial TB Strategy
Yukon: Provicinal TB Strategy
Northwest Territories: Provicinal TB Strategy
Nunavut: Provicinal TB Strategy
First Nations Specific TB Strategy
Inuit Specific TB Strategy
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