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<p>The standard treatment for tuberculosis (TB), which has been established since the 1970s, begins with the four drugs rifampicin, isoniazid, ethambutol and pyrazinamide over a&#xa0;period of 2&#xa0;months and continues with rifampicin and isoniazid for a&#xa0;total of 6&#xa0;months. Shortening the standard treatment to 4&#xa0;months, as recommended by the WHO, is not possible in Germany because the drug rifapentine, essential for this regimen, does not have approval in Europe. In cases of isoniazid resistance, the drug is replaced by levofloxacin and a&#xa0;6-month course of treatment with 4&#xa0;drugs is generally recommended. In cases of drug resistance to at least rifampicin, an individualized treatment of 18 months was recommended in Germany until 2022. Currently, in many cases the treatment can be shortened to 6&#xa0;months using new and better tolerated treatment combinations. The duration of treatment, the tolerability of the drugs and the often challenging circumstances can lead to treatment discontinuation, which increases the risk of recurrence and the development of drug resistance. Comprehensible patient education, close monitoring of treatment, active management of adverse drug reactions and intensive sociomedical support are crucial for treatment success in people with tuberculosis. In difficult treatment situations and in the event of complications, cooperation with centers should be sought. The website of the German Central Committee against Tuberculosis (DZK) provides practical tools to support treatment for tuberculosis, which has become a&#xa0;rare disease in Germany.</p>

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Update: Therapie der Tuberkulose

  • 期刊论文

  • 发表日期：

    2026年1月9日

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  • Ralf Otto-Knapp,
  • Brit Häcker,
  • Torsten Bauer

摘要

The standard treatment for tuberculosis (TB), which has been established since the 1970s, begins with the four drugs rifampicin, isoniazid, ethambutol and pyrazinamide over a period of 2 months and continues with rifampicin and isoniazid for a total of 6 months. Shortening the standard treatment to 4 months, as recommended by the WHO, is not possible in Germany because the drug rifapentine, essential for this regimen, does not have approval in Europe. In cases of isoniazid resistance, the drug is replaced by levofloxacin and a 6-month course of treatment with 4 drugs is generally recommended. In cases of drug resistance to at least rifampicin, an individualized treatment of 18 months was recommended in Germany until 2022. Currently, in many cases the treatment can be shortened to 6 months using new and better tolerated treatment combinations. The duration of treatment, the tolerability of the drugs and the often challenging circumstances can lead to treatment discontinuation, which increases the risk of recurrence and the development of drug resistance. Comprehensible patient education, close monitoring of treatment, active management of adverse drug reactions and intensive sociomedical support are crucial for treatment success in people with tuberculosis. In difficult treatment situations and in the event of complications, cooperation with centers should be sought. The website of the German Central Committee against Tuberculosis (DZK) provides practical tools to support treatment for tuberculosis, which has become a rare disease in Germany.