Tuberculosis treated with fewer capsules per day is the recommendation that the WHO has already made, with the new treatments available at the same time shortening the time needed to cure by two months. The new therapies would also contribute to better patient adherence to treatment, doctors believe.
Sensitive tuberculosis or “ordinary” tuberculosis can be treated today also with drugs that allow the use of a single capsule for the administration of two or even three antibiotics. The alignment with the new treatment would mean a shorter duration of the disease, better tolerated drugs and hence a better adherence to the patient’s treatment, in many cases where sensitive tuberculosis turns into multidrug-resistant tuberculosis in the middle, being an effect of treatment interruption as a result of the long period required for healing.
The World Health Organization (WHO) launched the recommendation to treat sensitive tuberculosis with a 4-month treatment, or 6 months in selected cases, pulmonologist Beatrice Mahler said, on the occasion of World Tuberculosis Day. The new treatment allows the administration of several antibiotics in a single capsule, today the treatment of sensitive tuberculosis involves at least 6 months of treatment with a maximum of 12 tablets/day. The minimum possible number today in Romania is 10 tablets administered daily, during the first two months of the disease, added Dr. Mahler.
“I believe that Romania needs an important step in terms of sensitive tuberculosis treatments, and this is already regulated at the international level. Namely, to have preparations that are combinations of antibiotics in one capsule, so that the patient does not take 10 capsules, he can take fewer, which, from all points of view, would be better.” Prof. Dr. Beatrice Mahler specified, for “Adevărul”. The move to four-month treatment instead of six months would mean abandoning a treatment schedule that has been available since the 1980s.
“Other recommendations for even shorter treatments will follow”
“Two months less treatment means less stigma, means better treatment adherence, means lower risk of dropout. And when the patient does not quit, there is less chance that the tuberculosis will become multidrug-resistant, that strain of tuberculosis, mycobacterium tuberculosis. The recommendation is quite new, but it is a recommendation that comes after some studies that have been done in recent years, because we have access to new medication and I am convinced that – taking into account the information that is available at the moment, from the research area – it is only a step, because there will be other recommendations for even shorter treatments for sensitive tuberculosis, which is extremely good and necessary”. added Dr. Mahler.
The new therapies, on the other hand, are not much more expensive than the drugs that are currently used, said the doctor Beatrice Mahler, and the price difference would be over-compensated from the economy that Romania could make from the decrease in the number of days of medical leave, patients thus having the possibility to return to work faster after healing. Another saving would come from the shortening of the allowance period (patients diagnosed with tuberculosis need quality food, which is why they receive an allowance) during the illness.
On the other hand, the dropout rate (patients drop out today and despite the relatively long period of therapy, their health status improves after the start of treatment) is expected to decrease with the change in the scheme.
“I personally appreciated this change extremely much, because it brings hope for the eradication of tuberculosis. Because we all want to reach a time when tuberculosis is an exception to the diagnosis, not a constant”Dr. Mahler also said.
The refugee crisis. How do you recognize the symptoms of TB. “The danger in case of treatment interruption is high”
Unfortunately, Romania remains the European champion in terms of the number of patients diagnosed with sensitive tuberculosis (TB). Even if multidrug-resistant tuberculosis (MDR-TB) does not put us in the same undesirable place, concern remains in this regard as well.
Most of the cases of MDR-TB, however, come from patients who have been diagnosed with TB dropping out of treatment. “There are very few cases of drug-resistant tuberculosis that occur through contact between healthy people and the sick patient, or those in which the epidemiological chain can be made. Many of the patients are usually patients who have taken treatment for tuberculosis before and are either treatment failures or dropouts,” stated Dr. Mahler.
Tuberculosis has become, from the disease of poverty, the disease of stress
Known decades ago as the “disease of poverty”, tuberculosis is today found in all social circles. Although many patients with a not very high financial status are treated for tuberculosis in hospitals, they are in fact the majority among those hospitalized, and even more follow the treatment at home.
“The number of patients requiring hospitalization compared to the number of tuberculosis cases is extremely small at the moment in Romania, because tuberculosis can be treated at home, which is normal, especially since a large part of people have the possibility to isolate themselves. Tuberculosis is unfortunately, for some sick people, a tuberculosis of people who work under stressful conditions, of those who do not understand or fail to adopt a certain lifestyle, fail to understand that stress management is essential, that you must sleep enough at night, that nutrition must be balanced and that chronic diseases must be treated correctly and on time”. the doctor pointed out.
Among patients with chronic diseases, people diagnosed with diabetes and cancer patients are at increased risk of developing tuberculosis. In the case of patients suffering from cancer, regardless of location, the situation becomes much more complicated, because in the first months of treatment for tuberculosis, the administration of cytostatic treatment is not allowed.
Tuberculosis remains among the top ten causes of death worldwide
Although it is a treatable disease, tuberculosis remains among the top ten causes of death worldwide due to unequal access to treatment. In 2024, according to data from the National Institute of Public Health (INSP) website, approximately 10.7 million people were diagnosed with tuberculosis worldwide, with the number of tuberculosis-related deaths estimated at approximately 1.3 million (of which 150,000 were people living with HIV). It is also estimated that about a quarter of the world’s population is infected with the tuberculosis bacterium.
Free analyzes in 16 municipalities to detect tuberculosis. Călărași County has among the most cases
In the WHO European Region, 170,000 new cases of tuberculosis were reported in 2024, “a significant part of them representing forms resistant to treatment”, say public health specialists. Romania remains the country in the European Union with the highest incidence of tuberculosis, with 44.3 cases per 100,000 inhabitants, and among children – 10.8 cases per 100,000 inhabitants.
“However, the past two decades have seen significant progress in controlling the disease. The number of tuberculosis cases fell by about 69%. If in 2002 over 30,000 new cases and relapses were reported annually, in 2024 their number decreased to approximately 8,400 cases. However, the decrease in incidence is not uniform throughout the country, being influenced by factors such as access to medical services, socio-economic conditions and the effectiveness of disease control measures”, according to INSP.
