TB Healing

TB treatment criteria I (was not infected, there is a history of contact, not suffering TB) and II (infected with the TB / test tuberkulin (+), but did not suffer tuberculosis (TB no symptoms, radiological and does not support negative bacteriology) requires the provision of prevention DOT 5-10 mg / kgbb / day.

1. Prevention (profilaksis) primary
Children in close contact with a TB sufferer BTA (+).
DOT at least 3 months despite testing tuberkulin (-).
Profilaksis therapy stopped when the test results back into tuberkulin (-) or a source of active TB transmission is not there.
2. Prevention (profilaksis) secondary
Children with TB infection is tuberkulin test (+) but no symptoms of TB illness.
Profilaksis given for 6-9 months.

Drugs used for TB are classified in two groups, namely:

* Medicine for primary: DOT (isoniazid), Rifampisin, Etambutol, streptomycin, Pirazinamid.
Shows the effectiveness with a high toksisitas that can be tolerated, most people can be cured with these medicines.
* Drugs secondary: Exionamid, Paraaminosalisilat, Sikloserin, Amikasin, Kapreomisin and Kanamisin.

Doses of medication antituberkulosis (OAT)
Doses of drugs daily
(mg / kgbb / day) Dosage 2x/minggu
(mg / kgbb / day) Dosage 3x/minggu
(mg / kgbb / day)
DOT 5-15 (max 300 mg) 15-40 (max. 900 mg) 15-40 (max. 900 mg)
Rifampisin 10-20 (max. 600 mg) 10-20 (max. 600 mg) 15-20 (max. 600 mg)
Pirazinamid 15-40 (max. 2 g) 50-70 (max. 4 g) 15-30 (max. 3 g)
Etambutol 15-25 (max. 2.5 g) 50 (max. 2.5 g) 15-25 (max. 2.5 g)
Streptomycin 15-40 (max. 1 g) 25-40 (max. 1.5 g) 25-40 (max. 1.5 g)

Since 1995, the program of TB disease in Indonesia to change management operations, adjusted with the global strategy yanng recommended by the WHO. This step is done to follow up Indonesia - the joint WHO Evaluation and the National Tuberculosis Program in Indonesia in April 1994. In this program, the priority is aimed at improving the quality of service and the rational use of medicines to decide the chain of transmission and prevent widespread resistance TB germs in community. This program is carried out oversee ways with the patient in swallowing medication every day, especially in the early phase of treatment.

DOTS strategy (directly Observed Treatment Short-course) was first introduced in 1996 and has been implemented extensively in community health service system. Until 2001, 98% of the population can access the DOTS services in the health center. This strategy is defined as "the direct supervision of swallowing drugs short-term treatment by supervisors" each day.

Indonesia is a high burden countries, and are expanding the DOTS strategy quickly, so the baseline drug susceptibility data (DST) will become a monitoring tool and indicator that the program is very important. Based on data from several areas, and identification of TB treatment through the hospital reached 20-50% of the cases BTA positive, and many more cases to BTA negative. If it does not work with health, so many patients diagnosed by hospitals have a higher risk of treatment failure, and may cause the immune drugs.

Due to lack of good people with TB treatment handling and weak implementation of the DOTS strategy. Collaboration with BTA that resisten against OAT will spread the infection with the TB bacteria that are MDR (Multi-Resistant drugs). For cases of MDR-TB drugs needed other than the standard drug treatment TB drugs, namely fluorokuinolon as siprofloksasin, ofloxacin, levofloxacin (only, unfortunately, that the drug is not recommended on children in infancy).
TB treatment in adults

* Category 1: 2HRZE/4H3R3
During the 2 months drinking drugs DOT, rifampisin, pirazinamid, and etambutol each day (intensive phase), and the next 4 months, drinking and drug DOT rifampisin three times a week (advanced stage).
Assigned to:
o Collaboration new lungs, TB BTA positive.
o Collaboration extra lungs, TB (TB in the lungs) weight.
* Category 2: HRZE/5H3R3E3
Assigned to:
o people relapse.
o People failed therapy.
o Collaboration with negligent medical treatment after drinking medicine.
* Category 3: 2HRZ/4H3R3
Assigned to:
o People BTA (+) and X-rays to support active tuberculosis.

TB treatment in children

The dose for a short-term TB treatment for 6 or 9 months, namely:

1. 2HR/7H2R2: DOT + Rifampisin each day during the first 2 months, and the DOT + Rifampisin every day or 2 times a week for 7 months (Etambutol added if there is suspected resistance against DOT).
2. 2HRZ/4H2R2: DOT Rifampisin + + Pirazinamid: every day during the first 2 months, and the DOT + Rifampisin every day or 2 times a week for 4 months (Etambutol added if there is suspected resistance against DOT).

TB treatment in children if the DOT and rifampisin given the same time, the maximum dose of 10 mg per DOT / kgbb and rifampisin 15 mg / kgbb.

Child and Dosers DOT rifampisin given to the case:

TB is not heavy
DOT: 5 mg / kgbb / day
Rifampisin: 10 mg / kgbb / day

TB weight (milier and TB meningitis)
DOT: 10 mg / kgbb / day
Rifampisin: 15 mg / kgbb / day
Prednison dose: 1-2 mg / kgbb / day (max. 60 mg)

Info : http://www.medicastore.com/tbc/pengobatan_tbc.htm