Nonsurgical treatment of osteoarticular tuberculosis. A retrospective study in 143 adults.
OBJECTIVE
Data are sparse on nonsurgical treatments currently used for osteoarticular tuberculosis in industrialized countries. We conducted a multicenter retrospective study in the Paris urban area, France, in 206 cases of osteoarticular tuberculosis documented by examination of a local specimen. This article reports our findings in the 143 patients who were followed up at least until treatment completion.


RESULTS
Mean follow-up after treatment completion was 16 months. Seventy-five (52%) patients had spondylitis and 68 (48%) did not. The number of antituberculous agents used during the initial treatment phase was four in 65% of cases and three in 35%. In the spondylitis subgroup, mean (+/- SD) antibiotic therapy duration was 14.7 +/- 3.4 months, and 25% of patients required surgery; 3% of patients died, 1% suffered a relapse, and 96% achieved a full recovery with no relapse. In the nonspondylitis subgroup, mean antibiotic therapy duration was 13 +/- 3 months and 29% of patients required surgery. The only HIV-positive patient had osteitis of the calcaneus with a relapse that led to discovery of secondary rifampin resistance.


CONCLUSIONS
Based on our findings and on data from the literature, we believe that 12 months is a reasonable duration for antituberculous therapy in osteoarticular tuberculosis, including tuberculous spondylitis.
Pertuiset
E
E
Rheumatology Unit, Viggo Petersen Center, Lariboisière Teaching Hospital, Paris, France.
Beaudreuil
J
J
Horusitzky
A
A
Lioté
F
F
Kemiche
F
F
Richette
P
P
Clerc-Weyl
D
D
Cerf-Payrastre
I
I
Dorfmann
H
H
Glowinski
J
J
Crouzet
J
J
Ziza
J M
JM
Bardin
T
T
Meyer
O
O
Dryll
A
A
Kahn
M F
MF
Kuntz
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013166:Spondylitis / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery
D000995:Antitubercular Agents