What is the Treatment Plan for Initially Diagnosed Pulmonary Tuberculosis?

Tuberculosis, as a chronic infectious disease, poses significant harm to patients. Although modern treatments for tuberculosis have achieved certain effectiveness and mortality rates are gradually decreasing, patients still experience various uncomfortable symptoms after contracting the disease. Early-stage tuberculosis patients can choose drug therapy, while more severe cases may require surgical intervention. Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis that can affect many organs, with lung infection being the most common manifestation. Infectious individuals play a crucial role in disease transmission. Infection with Mycobacterium tuberculosis does not necessarily lead to clinical illness, but it may develop when resistance decreases or cell-mediated hypersensitivity increases. Prompt diagnosis and reasonable treatment can often lead to clinical cure. The primary objectives of drug therapy are to shorten the infectious period, reduce mortality, infection rates, and prevalence. For individual patients, rationalized treatment refers to adhering to the principles of early initiation, combined use, appropriate dosage, regular administration, and full-course therapy with sensitive drugs for active tuberculosis. Rationalized treatment includes:

(1) Early treatment: Initiating drug therapy immediately upon diagnosis;

(2) Combination therapy: Using two or more drugs based on the patient's condition and the characteristics of anti-tuberculosis drugs to enhance and ensure therapeutic effectiveness;

(3) Appropriate dosage: Determining different dosing regimens based on individual conditions and patient characteristics;

(4) Regularity: Strictly adhering to the prescribed medication schedule, without altering the treatment plan or discontinuing medication without justification;

(5) Full-course therapy: Completing the prescribed treatment duration, typically 6 to 9 months for short-course therapy.

Generally, when primary patients adhere to these principles, the curative effect can reach up to 98% with a recurrence rate below 2%. Surgical intervention is now less commonly used in the treatment of tuberculosis. Surgical options may be considered in cases such as tuberculomas larger than 3 cm that are difficult to distinguish from lung cancer, recurrent unilateral fibrous thick-walled cavities unresponsive to long-term medical treatment, or unilateral destroyed lungs with bronchiectasis, loss of function, and recurrent hemoptysis or secondary infection. Pulmonary resection, either lobectomy or pneumonectomy, may be indicated in these situations. Surgical resection of the affected lung lobe and pleura may also be recommended in cases of tuberculous empyema or bronchopleural fistula that fail to respond to medical therapy and are associated with ipsilateral active tuberculosis.