PHYTOTHERAPY IN PHTHISIOLOGY: ANALYSIS OF ADJUNCTIVE APPROACHES DURING STANDARD ANTI-TUBERCULOSIS TREATMENT

Tuberculosis remains one of the most important infectious diseases worldwide and requires standardized, evidence-based antimicrobial therapy. However, long treatment duration, adverse drug reactions, nutritional vulnerability, oxidative stress, and poor adherence continue to complicate clinical management. In this context, phytotherapy has attracted scientific interest as a possible adjunctive approach in phthisiology. The aim of this article is to analyze the role, limitations, and safety considerations of herbal and plant-derived products used alongside standard anti-tuberculosis therapy. The study was designed as a narrative literature review based on international guidelines, clinical trials, systematic reviews, and pharmacological studies. The analysis shows that phytotherapy cannot replace anti-tuberculosis drugs and should not be promoted as an independent treatment for active tuberculosis. Nevertheless, selected plant-derived compounds may have supportive value in reducing oxidative stress, improving general well-being, supporting nutrition, and possibly decreasing the risk of drug-induced liver injury. Evidence is most frequently discussed for silymarin, curcumin, licorice-derived compounds, garlic preparations, green tea polyphenols, and certain traditional herbal formulations. At the same time, the quality of evidence remains heterogeneous, and concerns exist regarding hepatotoxicity, herb–drug interactions, contamination, and unregulated use. Therefore, phytotherapy in tuberculosis care should be applied only as an adjunctive, clinically supervised, and evidence-informed approach. Future studies should focus on standardized extracts, pharmacokinetic safety, randomized controlled trials, and integration with national tuberculosis programs.