title: Drug treatment of multidrug-resistant osteoarticular tuberculosis: a systematic literature review.
abstract: OBJECTIVE
  To review the literature in order to determine the best treatment options for multidrug-resistant tuberculosis (MDR-TB) of the skeletal system.
  
  
  METHODS
  We searched the PubMed database for all case reports of osteoarticular MDR-TB that provided information on drug treatment and clinical outcome.
  
  
  RESULTS
  We identified six cases with spinal MDR-TB and seven with extraspinal MDR-TB and reviewed their susceptibility tests, treatments administered, surgical treatments, and clinical outcomes. All patients had a successful clinical outcome (either cured or improved) except one who died due to septicemia. One patient with spinal MDR-TB and four patients with extraspinal MDR-TB had a successful outcome with medical treatment alone. Two patients who received treatment for a shorter time or with fewer drugs than recommended were cured with the addition of surgery.
  
  
  CONCLUSIONS
  Osteoarticular MDR-TB is very infrequently reported in the literature. The few cases reviewed suggest that it is possible to achieve a good outcome with second-line anti-tuberculous drugs, and that surgery might be useful for cases in which an optimized medical treatment is not possible.
authors.affiliation: Infectious Diseases Unit, Department of Internal Medicine, Hospital Infanta Sofía, Paseo de Europa, San Sebastián de los Reyes, Madrid, Spain. inessuarez@hotmail.com
authors.forename: Inés
authors.initials: I
authors.lastname: Suárez-García
authors.forename: Arturo
authors.initials: A
authors.lastname: Noguerado
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology; D014394:Tuberculosis, Osteoarticular / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents