Although antibiotics had been discovered a few years before, sulfonamide and penicillin proved no effect on the bacteria causing Tuberculosis. After years of research In California about soil fungus, in 1039 Waksman isolated the fungus Actynomices that was able to inhibit the development of Mycobacterium Tuberculosis. But the chemo was to dangerous toxic and could not be used in treating Tuberculosis.
In 1943streptomycin was found inside Streptomyces griseus and it was proven to totally inhibit the bacterial strains. In 1944 it was administered to a Tuberculosis patient that immediately improved. Although streptomycin causes side effects like damages to the inner ear, it was for a few years the best medication against Mycobacterium.
The medical treatment of Tuberculosis was put in danger after the assumption that bacteria rapidly gains resistance even to the newer discovered antibiotics. But the issue was quickly solved by using combinations of antibiotics in the treatment.
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After streptomycin other major anti Tuberculosis chemo were introduced. P-aminosalicilic acid, Isoniazid, Pyrazinamide, Ethambutol, Rifampicin and Cycloserin showed benefic results in the cure of Tuberculosis. Newer Aminiglicosides such as Viomycin and Kanamycin as well as the quinolones Ciprofloxacin and Ofloxacin are only prescribed in cases of resistant strains. Latest treatment methods like the Macrolides or the combination of Beta-lactamase and Beta-lactams have not been yet enough studied.
The two most important characteristics of the antituberculous ant biotherapy are:
1. The antibacterial activity best resulted in Streptomycin, Isoniazid and Rifampicin.
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2. The inhibition of the development of resistance with best results in Rifampicin, Ethambutol and Izoniazid.
After a month of treatment with the four basic antibiotics, the patient should be fever free, feel much improved and show decreased number of bacteria in the sputum. The weight of the patient must increase and the lesions visible on the X-rays should minimize. As the medication persists the bacterial organism in the sputum will become more and more difficult to be cultivated on synthetic cultures inside the laboratories.
If no signs of improvement appear on the radiography after 3 months, the medication and the patient's compliance must be again verified. Most relapses after treatment appear in the first 6 months after the patient has stopped taking chemo. Also the capacity of developing resistance must be taken into consideration. The National Tuberculosis Center must carefully monitories rebel cases of Tuberculosis.
In case of a recurrence at the same patient, doctors must find another schedule of therapy as the bacteria has already developed resistance to the antibiotics used before. A possibility is adding other few antibiotics to the initial medication. If bacteria is resistant to all kind of standard chemical products, other drugs, more toxic however will be put in the schedule: Ethionamide, Cycloserine, Viomycin, Kanamycin, Pyrazinamide or Capreomycin.
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