Free Content Chemotherapeutic treatment for spinal tuberculosis

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AIM: To evaluate whether 6 months of chemotherapy for patients with spinal tuberculosis prevents relapse as effectively as more than 6 months of chemotherapy.

METHOD: Literature review. Medline search including references, from January 1978 to November 2000. Inclusion criteria for publications: diagnosis of spinal tuberculosis confirmed bacteriologically and/or histologically, or probable on the basis of clinical and radiological parameters; treatment regimen (whether or not in combination with surgery) included isoniazid (H), rifampicin (R) and pyrazinamide (Z); follow-up period after completion of treatment of 12 months or more. Exclusion criteria: patients with relapse who had previously been treated adequately for tuberculosis.


RESULTS: Four publications were found with HRZ regimens of 6 months' duration and 10 publications with HRZ regimens of >6 months' duration. A number of patients had received HRE (E = ethambutol) for ≥9 months. In the results, no distinction was made between treatment groups. HRZ for 6 months led to a relapse rate of 0% (0/56, 95%CI 0.0–6.4); follow-up after surgical intervention ranged from 6 to 108 months. HRZ for ≥9 months (≥119 patients) or HRE for ≥9 months (≤71 patients) led to a relapse rate of 2% (4/218, 95%CI 0.6–5.0); follow-up after surgical intervention was 6–168 months. Despite the small number of studies, 6 months of therapy is probably sufficient for patients with spinal tuberculosis.

Keywords: isoniazid; pyrazinamide; relapse; rifampicin; spinal tuberculosis

Document Type: Regular Paper

Affiliations: 1: GGD Regio Nijmegen (Public Health Office), Nijmegen, The Netherlands 2: Department of Epidemiology and Biostatics, UMC Nijmegen, Nijmegen, The Netherlands 3: AZG (Academisch Ziekenhuis Groningen), Groningen, The Netherlands

Publication date: March 1, 2002

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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