Tuberculosis (TB) is a serious lung disease caused by Mycobacterium tuberculosis bacteria. While it primarily affects the lungs, TB can also affect other parts of the body and lead to life threatening complications.

The American Lung Association estimates that 10 million people have “active” tuberculosis worldwide, though the infection is far less common in the United States. Most cases are also curable.

“Most forms of Tuberculosis can be treated with antibiotics. Drug-resistant Tuberculosis is a form of the disease that isn’t responding to commonly used medications.”

Read on to learn more about the causes of drug-resistant Tuberculosis and the treatment options.

In most cases, drug-resistant TB develops when you don’t stick to your treatment plan. Not taking a full course of treatment or taking the wrong dosage can cause drug resistance.

TB itself is an airborne infection spread through prolonged exposure to someone who has an active TB infection. TB can be transmitted through droplets when a person with a TB infection:

  • Talks.
  • coughs
  • sneezes

After you inhale the bacterium that causes TB, it lodges in your lung tissues. From there, TB bacteria can spread into several areas of your body, including your:

  • There are lymph nodes.
  • skin
  • Other organs are major.

In the United States, doctors usually treat TB with a 4-month, 6-month, or 9-month course of medications.

The course includes the medications.

  • rifapentine
  • moxifloxacin is a drug.
  • Isoniazid is a drug.
  • pyrazinamide is a drug.

The course uses a regimen called RIPE.

  • rifampin
  • isoniazid
  • pyrazinamide
  • ethambutol

“If you don’t follow your treatment plan or if your condition doesn’t improve with first-line treatments, you could have drug-resistant Tuberculosis. The standard of treatment used to get rid of the disease is not resistant to the bacterium that is responsible for it.”

While it can take months or even years to develop TB after infection, you may be at a higher risk of contracting TB and developing an infection right away if you have a weakened immune system. This includes:

Additionally, you may be at risk of getting drug-resistant TB if you:

  • There is a place where there is a lot of Tuberculosis.
  • Someone has been exposed to drug-resistant Tuberculosis.
  • You may be exposed to others with drug-resistant Tuberculosis if you work in an industry or setting.
  • Have a history of being bitten by the disease.
  • Stop taking the medications

Depending on the drug you are resistant to, there are different types of drug-resistant Tuberculosis. First-line treatments for Tuberculosis are often considered with such medications. It is possible to have more than one type of drug-resistant Tuberculosis.

Drug-resistant Tuberculosis include:

  • Mono-resistant (MR-TB). You’re resistant to one first-line TB treatment.
  • Poly-resistant (PR-TB). You’re resistant to more than one first-line treatment, aside from Isoniazid is a drug. and rifampin.
  • Multidrug-resistant (MDR-TB). This is a more serious subtype where you may be resistant to more than one type of drug, particularly Isoniazid is a drug. and rifampin.
  • Rifampin-resistant (RR-TB). You’re resistant to rifampin.
  • Pre-extensively drug-resistant (pre-XDR-TB). You’re resistant to Isoniazid is a drug., rifampin, and fluoroquinolone antibiotics or a second-line injection, such as amikacin, capreomycin, and kanamycin.
  • Extensively drug-resistant (XDR-TB). You’re resistant to Isoniazid is a drug., rifampin, and a fluoroquinolone antibiotic, as well as bedaquiline, linezolid, or one of the three second-line injections. While XDR-TB is rare, it’s also the most serious type of drug-resistant TB if you have a weakened immune system.

Symptoms of TB include:

  • A worsening cough that lasts for 3 weeks or more.
  • coughing up blood or mucus
  • fatigue
  • weakness
  • There is a high degree of fever.
  • The night sweats on.
  • The appetite has been lost.
  • It is possible to lose weight unintentionally.

“Drug-resistant Tuberculosis doesn’t cause different symptoms. The symptoms don’t get better despite the use of traditional drugs. If you are not getting better despite your medication, you should see your doctor.”

In antibiotic-resistant infections, first-line medications don’t get rid of harmful bacteria. The bacteria may continue to grow and spread.

TB is traditionally diagnosed with a combination of:

  • Blood tests.
  • Lung X-rays.
  • Skin tests.

For doctors to determine drug resistance, they’ll need more tests. This usually involves taking a culture of bacteria and then exposing it to various drugs in a lab setting. While effective, the downside is that the process can take 2 to 3 days to complete.

It is possible to treat drug-resistant Tuberculosis, but you may not be able to take certain first-line medications. Treatment will depend on the type of drug-resistant Tuberculosis you have. Multiple antibiotic resistance makes XDR-TB the most challenging to treat.

Coming up with a regimen for drug-resistant TB is very complicated. It involves a combination of multiple antibiotics that depend on many complex factors. Options that your doctor may consider for treating drug-resistant TB include:

  • Using a different first-line treatment. This is common in the case of MR-TB.
  • Fluoroquinolone. This is a type of antibiotic prescribed only for more complicated infections. It has potentially serious and permanent side effects that affect the muscles, joints, and nervous system.
  • Bedaquiline-linezolid-pretomanid combination therapy. Research shows that this therapy may help after 6 months of use. Side effects may include neuropathy and vision problems.

Taking more second- or third-line treatments may cause more serious side effects.

Treating drug-resistant TB also takes longer. The World Health Organization’s 2020 guidelines suggest regimens that can last between 6 and 20 months.

“The best way to prevent drug-resistant Tuberculosis is to keep yourself safe from contracting the disease. You can protect yourself by avoiding people who are sick and by keeping up with your doctor’s prescribed drugs.”

If you come in close contact with someone who has recently developed an active Tuberculosis, you should see a doctor right away for testing. If you are diagnosed with Tuberculosis, you should talk to your doctor about your treatment options.

If your doctor finds that you have “latent” TB, which means it has not yet developed into a disease, they may recommend taking Isoniazid is a drug.. Depending on the regimen, the duration of this preventive treatment can vary from 3 to 9 months.

Also, you may help prevent drug-resistant TB by taking all of your TB medications as prescribed. Skipping doses or stopping treatment altogether may increase your risk of developing drug-resistant TB.

Whether you have traditional or drug-resistant TB, it’s also important to help reduce the spread of the bacteria to others if you can. It can take a few weeks for your medications to start working, so you may need to avoid contact with others during this time. You should also avoid going to school or work until your doctor says it’s safe to return.

Is there a vaccine for TB?

The Bacille Calmette-Guérin (BCG) vaccine is used in some countries to help prevent serious TB infections in children. However, the BCG vaccine isn’t used in the United States due to a general lack of efficacy overall.

Is drug-resistant TB spread the same way as regular TB?

Yes. Drug-resistant TB is also airborne and spreads through air droplets from a person with an active TB infection. What makes drug-resistant TB different is that the bacteria that cause the infection are resistant to medications normally used to treat it.

When did drug-resistant TB start?

While the exact timeline isn’t known, scientists first identified antibiotic resistance in the 1940s. Since then, more antibiotic-resistant infections have developed, with the Centers for Disease Control and Prevention (CDC) declaring antibiotic resistance one of the “most urgent public health problems” worldwide.

Is drug-resistant TB fatal?

Most cases of TB are curable. However, drug-resistant TB is more difficult to cure because the medications normally used to treat the infection don’t work. This type of bacterial resistance could increase the risk of death from TB, making early diagnosis critical.

Drug-resistant Tuberculosis is more difficult to cure due to a reduced response to first-line treatments. It is important to complete your course of treatment to avoid developing drug-resistant Tuberculosis.

Cost is another consideration. Long-term TB may result in loss of income due to an inability to go to work. The cost of treatment can range from $18,000 to $513,000.

It’s also important to keep in mind that TB is among many diseases that are becoming more resistant to traditional antibiotics. If you have a weakened immune system or other risk factors, talk with a doctor about ways you can protect yourself from potentially drug-resistant infections.