Pathophysiology
Clinical meaning
TB treatment requires multiple medications taken for an extended period (6-9 months minimum) to kill actively replicating bacteria AND dormant bacilli within granulomas. The standard regimen is RIPE therapy: Rifampin, Isoniazid, Pyrazinamide, and Ethambutol for the first 2 months (intensive phase), followed by Rifampin and Isoniazid for 4 months (continuation phase). Treatment failure from non-adherence leads to drug-resistant TB, which is much harder to treat.