Public Health

What It Takes To Cure Drug-Resistant Tuberculosis

  Tuberculosis Multidrug-resistant tuberculosis
Treatment 2 months with 4 drugs

Followed by 4 months with 2 drugs
8 months with 5 drugs and a shot

Followed by at least 20 months with 5 drugs
Total drugs consumed 854 pills swallowed 13,664 pills swallowed, 244 shots taken
Drug cost $20 $2,500 to $3,000
Possible side effects Rashes, nausea, liver failure Permanent hearing loss, permanent dizziness, kidney damage, psychosis, liver failure, nausea, rashes
Side effect rates 5 to 10 percent have mild to serious side effects At least 33 percent of patients have serious side effects

We recently chatted with Dr. Mel Spigelman, the president of TB Alliance, and he answered five common questions about tuberculosis. We edited his responses for length and clarity.

  1. How contagious is TB? Can you get it by being near someone when they sneeze? Probably not. TB requires relatively close contact for transmission. You really need to be around somebody for a good amount of time. That's why it spreads in families.
  2. An estimated one-third of the world has TB. How could that be? Not everybody who is infected with the TB bacteria gets sick. In many cases, the body walls off the microbes, usually in the lungs, and you never know they're there, kind of like the bacteria in your mouth or nose.
  3. Does the TB bacteria always break out of this friendly relationship and make you sick? A person has about a 10 percent chance during their lifetime for a latent TB infection to become an active one and cause problems. That risk increases if your immune system is compromised.
  4. If you test positive for TB with a skin test, do you always need treatment, even when you're not sick? Yes. In the U.S., people with latent TB infections traditionally take two antibiotics for six to nine months.
  5. What's the difference between regular TB and drug-resistant versions in terms of treatment? Regular TB takes about six to nine months to cure, with four antibiotics daily. Drug-resistant TB takes about two years to cure, and the treatment is much rougher. The drugs are more toxic, and only about 50 percent of people recover. That rate may be a little higher in the U.S.

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