Posted: March 30th, 2022
Aims of using combinational therapy
When TB patients do not achieve adequate control of their disease, the best course of action is to use combination therapy with minimum side effects to complete their treatment goals. The Combination therapy should be started as soon as possible to avoid complications and ensure treatment adherence. Combination of Isoniazid, rifampin, pyrazinamide, and ethambutol or streptomycin for two months, pyrazinamide is stopped, and Isoniazid plus rifampin are continued for further four months, in cases of isoniazid résistance, discontinue and continue with rifampin, pyrazinamide and ethambutol for entire six months.
The mechanisms that are involved in the prognosis of TB are diverse, monotherapy acts at one or two of its best at the disease progression, but the combination of drugs allows for action at different TB mechanisms. Combined drugs have a different mode of action, and their effect would be five times greater than using monotherapy.
The combination uses drugs of different modes of action, thereby decreasing the probability of resistance during treatment. The use of rifampicin monotherapy rapidly leads to resistance even when given for short periods. In combination, Isoniazid reduces the likelihood of the survival of rifampicin resistance mutants. multidrug resistance refers to the resistance of atleast two of first-line anti-tuberculosis ( rifampicin and Isoniazid)
Drugs of combinational therapy are used at the optimal dose, reducing the risk of side effect and reducing the risk of emergence of drug-resistant tuberculosis.
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