Which medications are used in the treatment of Pott disease (tuberculous [TB] spondylitis)?

Updated: Aug 08, 2019
  • Author: Jose A Hidalgo, MD; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

A 4-drug regimen should be used empirically to treat Pott disease. Treatment can be adjusted when susceptibility information becomes available.

Isoniazid and rifampin should be administered during the whole course of therapy. Additional drugs are administered during the first 2 months of therapy and are generally chosen from among the first-line drugs, such as pyrazinamide, ethambutol, and streptomycin. (A 3-drug regimen usually includes isoniazid, rifampin, and pyrazinamide.) In cases of drug resistance, the use of second-line medications is indicated.

The duration of treatment is somewhat controversial. Although some studies favor a 6- to 9-month course, traditional courses range from 9 months to longer than 1 year. The duration of therapy should be individualized and based on the resolution of active symptoms and the clinical stability of the patient. [64, 65]


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