Duration of chemotherapy in tuberculosis is a controversial issue. This is an area where there is no consensus. According to World Health Organization, the spinal tuberculosis is a severe form of extrapulmonary tuberculosis and is assigned to CategoryI. All other cases are placed in category II.
Therefore, by WHO criteria, all caries spine cases should be treated for a minimum of 6 months and others for 5 months. However, many surgeons in India [where the disease in endemic] prefer to continue treatment till there is adequate radiological evidence of healing, which can take much longer than 6 months. The practiced range of duration is 1-1.5 years.
However in a systematic review of chemotherapeutic treatment for spinal TB, it was concluded that 6 months of therapy is probably sufficient for the majority of patients.
The United States Centers for Disease Control recommends that for infants and children with miliary tuberculosis or bone and joint TB treatment should last at least 12 months. For adults with these forms of extrapulmonary TB, the patient’s response to therapy should be monitored closely. If response is slow or inadequate, treatment may be prolonged on a case-by-case basis. Treatment would probably be needed to be prolonged in immunocompromised subject and in the absence of surgical debridement.
Popularity: 2% [?]
Related posts:
mx test 20 mm,PCR negative IgM negative MRI Not clear TLC DLC normal ESR 29mm No fever,, Pain in Lumber region after sleeping Is this caries spine
Dr Arun Pal Singh Reply:
September 27th, 2010 at 11:26 pm
@usha rani,
Why are you suspecting Caries spine? Anything there in your investigations to suggest?
Hi everybody, Namaste and Good Day. One of my close relative from northern India is diagnosed as having arthritis tuberculosis of the pelvis joint and since past 7 weeks is being treated in Kathmandu by a very well known doctor who has suggested continuing the TB medicine for 18 months. She developed extreme pain in the hip joint and causing the right knee bending with great pain if tried to stretch. Is this kind of tuberculosis treatment available in Darjeeling District and if so where ? I would be most grateful for a positive reply since the patient needs to go to Darjeeling area. Many thanks in advance.
Dr Arun Pal Singh Reply:
June 10th, 2011 at 2:50 pm
@Bhakta B.Tamang,
It would be better if you put this question to the local doctors where you wish the patient to be treated.