Chemotherapeutic treatment for spinal tuberculosis.
OBJECTIVE
To evaluate whether 6 months of chemotherapy for patients with spinal tuberculosis prevents relapse as effectively as more than 6 months of chemotherapy.


METHODS
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.


METHODS
patients with relapse who had previously been treated adequately for tuberculosis.


METHODS
Relapse rate.


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 > or = 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 > or = 9 months (> or = 119 patients) or HRE for > or = 9 months (< or = 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.
van Loenhout-Rooyackers
J H
JH
GGD Regio Nijmegen (Public Health Office), The Netherlands. jloenhout@GGD-Nijmegen.nl
Verbeek
A L M
AL
Jutte
P C
PC
D000328:Adult; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage* / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D011718:Pyrazinamide / Q000008:administration & dosage* / Q000627:therapeutic use; D012008:Recurrence; D012293:Rifampin / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy* / Q000473:pathology
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin