Nonsurgical treatment of osteoarticular tuberculosis - A retrospective study in 143 adults

Objective and methods. Data are sparse on nonsurgical treatments currently used for osteoarticular tuberculosis in industrialized countries. We conduc ted a multicenter retrospective study in the Paris urban area, Prance, in 2 06 cases of osteoarticular tuberculosis documented by examination of a loca l specimen. This article reports our findings in the 143 patients who were followed up at least until treatment completion. Results. Mean follow-up af ter treatment completion was 16 months. Seventy-five (52%) patients had spo ndylitis and 68 (48%) did not. The number of antituberculous agents used du ring 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 die d, 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 patien t had osteitis of the calcaneus with a relapse that led to discovery of sec ondary rifampin resistance. Conclusion. Based on our findings and on data f rom the literature, we believe that 12 months is a reasonable duration for antituberculous therapy in osteoarticular tuberculosis. including tuberculo us spondylitis.