Tuberculosis and Chest Service Department of Health - History of TB Treatment
 
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History of TB Treatment

The development of treatment for TB can be roughly classified into 3 stages:

  1. Classical approach
    • In the old days, before the discovery of the TB germ, there had been beliefs on various treatment methods, such as letting out of blood, avoidance of taking meat and alcohol, so as to keep the body fluids in balance; patients moving away from overcrowded living environment, and staying in temperate areas.
  2. Sanatorium
    • In the 1850's, sanatoria were built in Western Europe and America. They could provide environment with high attitude, fresh air and nutritious food for the TB patients. At that time, surgical treatment was quite widely used for treating TB patients, such as artificial pneumothorax, lobectomy, and pneumonectomy. However, after the discovery of effective drugs, these surgical procedures were seldom used.
  3. Chemotherapy
    • During different time periods, various agents were tried for the treatment of TB: mercury, iodine, creosote, etc.
    • In 1890, Dr. Robert Koch discovered tuberculin and tried it for treatment of TB.
    • In 1938, Rich & Follis reported that sulfanilamide could inhibit the growth of TB germs in guinea pigs.But this drug could not be applied for treatment in human beings.
    • In 1945, streptomycin was discovered. This marked a big step forward in the treatment of tuberculosis. However, initial response was soon followed by deterioration and development of drug resistance.Other drugs were also discovered subsequently: para-aminosalicylic acid, isoniazid, pyrazinamide, etc.

 


With continuous research and development, it was recognized that several anti-TB drugs needed to be used together for treatment of TB. The availability of effective treatment gave rise to important impact on the disease:

  1. TB is no longer a lethal disease, but can be cured effectively with medications.
  2. There is no need for TB patients to stay in beds in sanatorium for prolonged periods.
  3. There is no need for TB patients to undergo surgical operations for their TB.

The advent of rifampicin in the late 1970's marked the beginning of the era of short course therapy. The treatment duration for TB can be shortened from more than 2 years to a period of 6 months.

The development of effective anti-TB drug regimes drastically improved the world TB situation with drop in both incidence rates and death rates.However, due to various reasons since late 1980's, there had been resurgence of TB in various parts of the world.The epidemic of drug-resistant strains in certain places made it even more difficult to control. Hence in 1993, the World Health Organization declared TB as a global emergency and called for international collaboration in the fight against this disease.