Chemotherapy in bone and joint tuberculosis

Bone and joint tuberculosis, as all other types of tuberculosis is generall y treated with antituberculotic combination chemotherapy. This has to be co ntinued for a minimum of six months, or nine months in case of extensive sp reading. A two- to three-month initial phase with four or five different dr ugs (H, R, Z, and additionally E and/or S) is followed by a four- to six-mo nth therapy with H and R alone, provided the pathogen is fully susceptible to a standard regimen. The main side effects are hepatotoxic or allergic re actions. A frequent contra-indication is existing, often toxicity-induced, liver damage. The main local complications requiring surgery are spinal ins tability or neurologic deficiencies.