Chemotherapy in bone and joint tuberculosis.

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