The most effective treatment for tuberculosis (TB) is a course of antibiotics. This applies to current, symptomatic TB infections (active TB) as well as asymptomatic infections in which dormant TB bacteria are present in the body (latent TB). As long as the entire course of antibiotics are taken, and the bacterial strain is not antibiotic-resistant, antibiotics almost always cure TB.

Some of the antibiotics prescribed for TB have a number of side effects. Some types can turn the color of a person’s saliva, urine or tears orange. Other types may interfere with additional medications patients may be taking. Some of the more severe side effects of TB antibiotics may include nausea, vomiting, jaundice (yellowing of skin or eyes), rash, vision or hearing problems, tingling in the fingers or toes, and fever. Patients who experience any of these symptoms while taking medications to treat TB should immediately consult their physician.

Usually, patients with TB are initially prescribed several different types of antibiotics to ensure that all the TB bacteria are killed. Some of these antibiotic combinations may be available in a single-pill form. After a certain length of time, the number of different medications necessary may be reduced. TB bacteria are slow to respond to treatment. Thus, antibiotics must be taken regularly (usually every day) for between six months and a year. Additionally, women who are pregnant and being treated for TB may need to take vitamin B6 supplements.

After two or three weeks of treatment, the symptoms of TB begin to disappear and the disease is no longer contagious. However, despite a lack of symptoms, it is vital that TB patients continue to take the entire course of their medications. If antibiotics are stopped before all the bacteria are killed, the remaining bacteria may grow resistant to the antibiotics that were used. This can result in the development of multidrug-resistant TB (MDR TB) that are more deadly and harder to treat.

Because of the importance of continuous treatment, many health departments offer a program called directly observed therapy (DOT). With DOT treatment, a patient meets with a healthcare worker every day or several times a week to take the TB medication. The healthcare worker can observe that the medication has been administered and also answer any questions the patient may have about treatment. If a patient does not participate in DOT, it is still important to maintain contact with a physician on a regular basis to ensure that treatment is progressing.

Patients with HIV who receive effective treatment are likely to completely recover from TB. However, developing a treatment plan that is effective can be a difficult task. People with HIV are at a significantly higher risk of being infected with MDR TB. These antibiotic-resistant bacteria are often immune to the effects of the medications usually prescribed to treat TB.

People with MDR TB may be forced to use second-line antibiotics, many of which may have serious side effects. Additionally, some of the common TB antibiotics (both first- and second-line types) can adversely interact with medications used to treat HIV (e.g., antiretroviral agents). It is important that patients with both HIV and TB consult a physician who is a specialist in both diseases in order to explore all possible treatment options. If suitable medications are not found, TB may be fatal within months of its diagnosis in these patients. In addition, studies have shown that TB bacteria may accelerate the progression of HIV towards AIDS.

In rare cases, surgery may be necessary to remove part of the lung or other organs that have been damaged by the TB bacteria.

If active TB is left untreated, it is more likely to spread to other parts of the body and can cause permanent damage and death. If latent TB is left untreated, it can reactivate later in life when the immune system becomes weak. This causes the patient to experience symptoms of an active infection, and creates the possibility that the patient can spread TB to others.