Back to Search
Start Over
Treatment Outcome of Drug-Resistant Skeletal Tuberculosis: A Retrospective Analysis.
- Source :
-
Indian Journal of Orthopaedics . Apr2024, Vol. 58 Issue 4, p402-411. 10p. - Publication Year :
- 2024
-
Abstract
- Background: Management outcomes of drug-resistant (DR) osteoarticular tuberculosis (OATB) is dismal as in pre-ATT era (1905). The studies documenting treatment outcome of DR-OATB are scarce; hence, present retrospective analysis was conducted to evaluate outcome of consecutive cases of DR-OATB. Methods: 45 consecutive patients of suspected DR-OATB were treated from 2010 onwards. Tissue samples were submitted for AFB smear, cytology/histology, liquid culture, CBNAAT/LPA besides gram's staining and aerobic/anaerobic culture. Patients were treated by individualized second-line ATT till documenting healed status by contrast MRI/PET. The changes in neurological deficit, deformities, and drug-induced adverse events were documented. Results: 37/45 patients, 15 males and 22 females, mean age 26.89 years were followed. DR was suspected observing poor clinico-radiological response/appearance of fresh lesions on ATT. All showed no growth on aerobic/anaerobic pyogenic culture. 29 (78%) had microbiologically proven drug resistance and 8 (22%) were labeled as clinical drug resistance (CDR). 18/29 had multi-drug resistance. Mean prior ATT intake was 12.03 months 15 (40%) underwent surgical decompression. Mean duration of second-line ATT was 22.5 months (9–36 months). All patients achieved healed status with 8 (21%) developed side effects, most commonly hepatotoxicity, ototoxicity, and psychiatric disturbances. Average follow-up after completion of ATT was 40.5 months. Conclusion: We report a large series where patients of DR-OATB were suspected on clinical criteria, investigated by DST, and treated. Patients with proven drug resistance were treated by individualized second-line ATT. CDR cases were treated by MDR protocol. Genotypic DST (CBNAAT/LPA) improved demonstration of DR. We demonstrated healed status on MRI/PET with no recurrence at minimum 2-year follow-up. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HEPATOTOXICOLOGY
*TREATMENT effectiveness
*RETROSPECTIVE studies
*MAGNETIC resonance imaging
*POSITRON emission tomography
*DESCRIPTIVE statistics
*CELL culture
*OTOTOXICITY
*PSYCHOSES
*SURGICAL decompression
*PHENOTYPES
*GENOTYPES
*TIME
*EVALUATION
TUBERCULOSIS of the bones
JOINT tuberculosis
Subjects
Details
- Language :
- English
- ISSN :
- 00195413
- Volume :
- 58
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Indian Journal of Orthopaedics
- Publication Type :
- Academic Journal
- Accession number :
- 176249776
- Full Text :
- https://doi.org/10.1007/s43465-024-01110-w