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Int J Infect Dis. 2012 Nov;16(11):e774-8. doi: 10.1016/j.ijid.2012.07.011. Epub 2012 Aug 30.

Drug treatment of multidrug-resistant osteoarticular tuberculosis: a systematic literature review.

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  • 1Infectious Diseases Unit, Department of Internal Medicine, Hospital Infanta Sofía, Paseo de Europa, San Sebastián de los Reyes, Madrid, Spain. inessuarez@hotmail.com



To review the literature in order to determine the best treatment options for multidrug-resistant tuberculosis (MDR-TB) of the skeletal system.


We searched the PubMed database for all case reports of osteoarticular MDR-TB that provided information on drug treatment and clinical outcome.


We identified six cases with spinal MDR-TB and seven with extraspinal MDR-TB and reviewed their susceptibility tests, treatments administered, surgical treatments, and clinical outcomes. All patients had a successful clinical outcome (either cured or improved) except one who died due to septicemia. One patient with spinal MDR-TB and four patients with extraspinal MDR-TB had a successful outcome with medical treatment alone. Two patients who received treatment for a shorter time or with fewer drugs than recommended were cured with the addition of surgery.


Osteoarticular MDR-TB is very infrequently reported in the literature. The few cases reviewed suggest that it is possible to achieve a good outcome with second-line anti-tuberculous drugs, and that surgery might be useful for cases in which an optimized medical treatment is not possible.

Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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