An evaluation of the current therapeutic regimen for renal tuberculosis.

Renal tuberculosis will continue to be a potentially lethal disease and must be considered a diagnostic possibility in all patients with infection in order to discover it in time. Multiple drug regimens have withstood the test of time and it appears that triple drug therapy is more efficacious than 2 drugs since triple drugs permit the skipping of 1 or another of the medications with less danger of relapse. Rifampin is a new drug that is well tolerated and efficacious, although expensive. We recommend continuous use of triple drugs for 2 years at least with the continuance of pyridoxine. We advise an excretory urogram, the collection of 3 urine specimens for culture and the passage of ureteral catheters every 6 months during treatment and every 12 months thereafter for 10 years. We do not consider relapse an indication for an operation but for further therapy, using medications to which the patient's organism is proved susceptible by bacteriologic means. Under modern conditions an operation is rarely necessary.