The main objectives in TB treatment according to Botswana national tuberculosis

programme manual to is to: (1) cure the patient of TB by rapidly eliminating most of the bacilli, (2) to
prevent death from active TB or its late effects ,(3) prevent relapse of TB by eliminating the dormant
bacilli, (4) prevent the development of drug-resistance (by using a combination of drugs) (5) prevent the
transmission of TB to others,
The manual presents the first line of drugs that are for treating new and retreatment cases of TB and them
are presented in table 1 with their recommended doses. According to the manual These drugs (Anti-TB
drugs) possess three main properties which bactericidal action, sterilizing action and the ability to prevent
resistance.
Essential drug
Isoniazid
Rifampicin
Pyrazinamide
Ethambutol
Streptomycin

Recommended daily dose in mg/kg body weight

(range)
5 mg (4-6)
Maximum 300mg daily
10 mg (8-12)
Maximum 600mg daily
25 mg (20-30)
Adults 15 mg (15-25)
Children: 20 mg/kg (range 15-25 mg/kg) daily
15 mg (12-18)
Maximum for <40 years = 1g
Maximum for 40 years = 0.75g

Anti-TB treatment consists of an phases and the major one is intensive phase (also described as an
initial phase) of at least four drugs for at least two months, and a continuation phase of at least two
drugs for at least four months. The intensive phase is a very important part of treatment and is effective in
eliminating infectious bacilli and minimizing the development of resistant strains. The continuation phase
is necessary to minimize relapse
Patients need to be educated about the possibility of side effects, and encouraged to report any unusual
sign or symptom that might occur after start of anti-TB-treatment, as side effects are common with antiTB drugs. Although most side effects are minor, 3-6% of patients develop severe side effects that may
warrant stopping the offending drug or changing the regimen. All health workers involved in TB
treatment should know the most common side effects of the anti-TB-drug. Patients also needs to be
educated about the drug interactions.TB anti drugs interact with certain medication and this can be very
harmful to the patient. The below table present the side effects and drug interaction of anti TB drugs
according to the treatment manual of Botswana

Drug
ISONIAZIDE
RIFAMPCIN
PYRAZINAMIDE
ETHAMBUTOL

STREPTOMYCIN

Adverse effects
Hepatotoxicity, neurotoxicity,
haematological effects
Hepatotoxicity, anorexia, mental
confusion
Hyperuricemia, discolor body
fluids
Ocular toxicity, peripheral
neuropathy ,toxic damage to the
kidneys
Ototoxicity, nephrotoxicity,
Hypersensitivity

Warfarin, rifampcin, theophylline, alcohol and

paracetamol
Phenytoin. warfarin, oral contraceptives, digoxin
Allopurinol, probenecid, Ethambutol
Pyrazinamide and diuretics

Ethacrynic acid, furosemide, mannitol, diuretics.