Health Tips

Can I skip my anti-TB medications for a day or two?

Tuberculosis, a curable bacterial infection. The bacteria (Mycobacterium tuberculosis) infects the lung, or the other body parts. Infected individuals might have night sweats, prolonged cough which lasts more than 3 weeks, fever, chest pain, sudden weight loss, or difficulty in breathing.

Anti-tuberculosis medication

Usually, infected individuals are treated daily with the first line, 4 anti-TB drugs namely Isoniazid, Rifampicin, Ethambutol and Pyrazinamide for the first 2 months (intensive phase), followed by Isoniazid and Rifampicin for the subsequent 4 months (maintenance phase). Hence it takes at least a total of 6 months to get complete eradication of the bacteria. An additional medication, Pyridoxine is also added in the regimen to prevent numbness and tingling of the hands and feet that may be caused by Isoniazid.

This is where the problems come in.

A lot of them ditch the treatment because of the pill burden (taking 4 pills at once), side effects of medication experienced and due to the lengthy treatment period.

What will happen if anti-TB is not taken as per the doctors' advice?

• TB bacteria will start growing again

• Your treatment period might be extended (can be up to a year!)

• Stronger antibiotics might be needed (which is not a good thing as this means the TB bacteria has developed resistance to your current medications—meaning they can no longer kill the bacteria). Also, stronger antibiotics usually have more serious side effects.

Do I really need to take antibiotics for that long a.k.a. 6 months?

Certainly YES!

As mentioned earlier, TB bacteria needs a longer period of time to be completely eradicated. This is because they die very slowly. Even if you are feeling better after taking the anti-TB medications a few weeks later, it does not mean that you are cured and will still need to continue to take the medication as the TB bacteria is still in your body!

Sticking to your treatment 

1. Use of single pill (4-in-1) therapy

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Due to its simplicity, fixed dose combination drug such as Akurit-4 is preferred as it promotes compliance and directly reduces the likelihood of patients developing drug-resistant TB. And this condition usually happens when you stop taking the medications even before the course of treatment is completed or you do not take your medications daily as prescribed. This will result in the bacteria being resistant to the current anti-TB regimen. This situation will leave your doctor with lesser choice of drugs to be used for as part of the TB treatment.

2. Directly observed therapy (DOTS)

This therapy involves a healthcare professional, in which you will need to meet him/her every day or several times a week, so that they can make sure that you are taking your medications everyday correctly---by watching you swallow each and every pill prescribed. DOTS are compulsory for at least the first 2 months, which is usually provided by various Klinik Kesihatan. Other than that, they also take the opportunity during DOTS to monitor for any side effects of anti-TB and address your queries regarding TB and the treatment.

3. Self-reminder

For the remaining treatment during maintenance phase, you can opt for self-reminder to take the anti-TB. Set a reminder or alarm on your phone to remind you every day or have your family members or friends to remind you. You may also utilize a daily pill dispenser. Take your pill(s) at the same time every day so that you are conditioned to do so for the following months.

All in all

Treating tuberculosis is a long journey with constant effort. The key to being cured is to never miss or skip your medications. Seek for medical help if you are facing trouble taking anti-tuberculosis medications. 

Medically reviewed by Ashwini Nair, MB BCh BAO.

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References:

1. Adherence to tuberculosis treatment - UpToDate. Accessed March 17, 2022. https://www.uptodate.com/contents/adherence-to-tuberculosis-treatment#H1

2. Questions and Answers About Tuberculosis | TB | CDC. Published August 4, 2021. Accessed March 17, 2022. https://www.cdc.gov/tb/publications/faqs/tb-qa.htm

Written by

DOC2US Editorial Team