Tuberculosis (TB)

Tuberculosis (TB)

What is Tuberculosis (TB)?
Tuberculosis (TB) is an infectious disease that mostly affects the lungs (pulmonary) but
it can also affect any part of the body, such as the:

• Brain
• Lymph glands
• Spine
• Kidneys
• Eyes

How is it caught?
When someone with TB in their lungs coughs, sneezes, talks loudly or sings the bacteria
are expelled into the air. In an enclosed environment these tiny droplets can remain
suspended in the air for several hours. The infection can be transmitted to another
person when they breathe in these droplets. The people most at risk of developing TB
are those who live in the same house as the person with TB disease.

Am I infectious?
Not all people with TB are infectious.

You are only infectious to other people if you have TB in your lungs or throat and you
are coughing up TB bacteria. If you have TB anywhere else in your body you will not
be infectious.

If you have pulmonary TB you will need to stay at home and limit your activities to
prevent the spread of infectious TB but once you have been on continuous treatment
for two weeks you should be able to return to work. Your consultant and TB specialist
nurse will discuss this with you in more detail. Please see TB service home isolation
leaflet for more information.

Your TB specialist nurse will also discuss your family and friends with you. This will allow
us to decide which of them has had prolonged contact with you and are more likely to
be at risk of infection. We will then arrange to see them and organize investigations.

How is TB treated?
You will be looked after as an outpatient by a doctor and a nurse who specialize in TB,
unless you are very unwell and need to be admitted to hospital.

TB is treated with a combination of antibiotics for at least six months. The length of
treatment depends on whether the TB bacteria are resistant to any of the antibiotics and
where the TB is in your body.

The treatment may be prolonged if you do not take your tablets as prescribed by your
doctor.

What is the standard treatment for TB?
Your doctor will give you four different antibiotics for 2 months. The most commonly
used drugs are Rifampicin, Isoniazid, Pyrazinamide and Ethambutol.

Rifampicin, Isoniazid and Pyrazinamide may be given in a combined drug called Rifater
or all four may be given in a combined tablet called Voractiv.

After two months the antibiotics are usually reduced to just two – Rifampicin and
Isoniazid – these may be given in a combined drug called Rifinah. These need to be
taken for at least four months.

You will be given a vitamin tablet called Pyridoxine which will help to prevent any side
effects from the Isoniazid such as pins and needles to the hands and feet.

Does TB medication have any side effects?
As with all medicines there may be some side effects such as

• Orange discoloration of body fluids (urine, tears, sperm)
• Nausea
• Skin rashes
• Pins and needles

Other side effects may be more serious such as

• Eye problems
• Dizziness
• Persistent vomiting
• Jaundice (yellowing of skin or eyes)
• Severe upper abdominal pain

The effectiveness of hormonal contraception is reduced and women should use
additional means of contraception while they are taking these drugs and for 28 days
after completing treatment.

Rifampicin may cause permanent discoloration of soft contact lenses.

Information about the different tablets and their side effects can be obtained from your
TB nurse. It is always advisable to read the leaflets that accompany your medication
before you take them.

Minor problems should be reported to your TB Nurse or GP but if you experience any
major side effects, you should stop taking the medication and contact your TB Nurse or
GP urgently. Out of hours ring NHS 111.

The antibiotics for tuberculosis can be taken safely during pregnancy. Your doctor or
nurse will arrange some tests and investigations before you start your treatment.

How often should I take my medication?
All medication must be taken together by mouth, once a day at roughly the same time,
on an empty stomach (30 minutes before food) or 2 hours after eating to aid absorption.

If you miss a dose take it as soon as you can. If it is time for the next dose take it but do
not take a double dose. Please tell your nurse or doctor is this happens.

Why do I need to take my medication regularly?
TB bacteria are killed very slowly. It takes at least six months for the antibiotics to kill all
of the bacteria.

You must continue to take your medication until the doctor tells you to stop treatment.

Stopping your treatment too soon or not taking the antibiotics as prescribed is unsafe.
You may become resistant to the antibiotics and develop a type of TB which is difficult
and sometimes impossible to treat.

It is therefore very important that you do not miss any doses of your treatment.

What about other medication I am taking?
It is very important to tell your doctor if you are taking any other medications. There are
several medications that can interact with your TB antibiotics causing them not to work
or to have a reduced efficacy.

Is there anything I should avoid eating and drinking?
Some foods such as mature cheeses, cured meats, pickled herring, Bovril®, Oxo®,
Marmite® and fish such as tuna, mackerel and salmon contain ingredients that can
interact with your TB medications so these should be reduced.

You should also avoid drinking alcohol to help protect your liver.

How can I remember to take my medication?
You will be taking your TB antibiotics for at least 6 months so it is important that you get
into a routine. Here are some ways to help you take your medications regularly

• Take your tablets at the same time every day and leave them in the same place.
• Take your tablets to bed with you at night so that you can take them as soon a you wake up in the morning
• Some patients prefer to take their medication at night before going to bed
• Put your tablets in a weekly dispenser
• Mark off each day on a calendar as you take your medication
• Try setting an alarm to remind you to take your tablets
• Ask a family member or friend to remind you to take your medication. If you still forget, your TB nurse may be able to arrange someone to observe you taking your tablets
• Tell your doctor or nurse if you miss any doses of medication as they will try to help you

Will I be monitored throughout my treatment?
Your TB nurse will provide you with their contact details.

You will be contacted monthly where you will be monitored and supported by the TB
team.

Help to stop smoking
If you stop smoking your TB medication will work more effectively – find out more about
stopping smoking at www.blf.org.uk/smoking

More Information about TB
If you have TB and would like to know more about it from someone who has had the
disease, there is a registered charity for TB called TB Alert.

Their website contains lots of information about TB and support for people with the
disease from the people who have experienced the disease themselves.

They can be found on www.tbalert.org

NHS Choices – for information about TB www.nhs.uk/conditions/tuberculosis

Useful information
Please contact your TB nurse if you would like further information.

Telephone number 01562 512316or email [email protected]

The TB service is available Monday to Friday 08:30-16:30

An answerphone is in operation outside of these hours and on Bank Holidays.

TB Specialist Nurses Office
Cardiac Rehab Department
C Block Level 1
Kidderminster Hospital
DY11 6RJ

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best placed
to answer any questions or resolve concerns quickly. If the relevant member of staff is
unable to help resolve your concern, you can contact the PALS Team. We offer informal
help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate
your concerns. You can make a complaint orally, electronically or in writing and we can
advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please
be aware that you may need to leave a voicemail message, but we aim to return your
call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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