Administration Of Anti-tuberculosis Drugs Research Articles

Differences in Vitamin D3 Levels in Pulmonary Tuberculosis Patients Before and After One Month of Anti-Tuberculosis Drug Therapy

Pulmonary tuberculosis is an infectious disease caused by infection with the bacteria Mycobacterium tuberculosis. Patients diagnosed with pulmonary tuberculosis will receive Anti-Tuberculosis Drug (OAT) therapy for six months. In the first two months or what is called the intensive phase, the patient will be given a combination of OAT in the form of rifampicin, isoniazid, ethambutol and pyrazinamide. Several types of anti-tuberculosis drugs have the potential to affect vitamin D3 metabolism, either by interfering with absorption, metabolism or changing the action of vitamin D3. The long-term treatment process for pulmonary tuberculosis also results in a decrease in vitamin D3 levels in the blood. This study aims to determine the difference in vitamin D3 levels in pulmonary tuberculosis sufferers before and after one month of anti-tuberculosis drug therapy. This type of research is descriptive observational with a prospective cohort design without comparison. The total sample was 16 newly diagnosed pulmonary tuberculosis sufferers at the Bangetayu, Kedungmundu and Tlogosari Wetan Health Centers, Semarang City. Vitamin D3 levels in serum samples were examined using the ELISA method. The mean vitamin D3 level before OAT therapy was 19.00 ± 10.45 ng/mL, the level decreased after OAT therapy, namely 18.51 ± 4.74 ng/mL. These results indicate that administration of anti-tuberculosis drugs may have an effect on vitamin levels.

Safety profile of antituberculosis drugs

Studying the safety profile of antituberculosis drugs is a priority for the development of a treatment regimen as efficient as possible and with a high degree of tolerability for patients. The development of side adverse reactions of antituberculosis drugs continues to remain one of the main causes of low compliance or even abandonment of the administered treatment. The detection, reporting and analysis of adverse effects associated with the administration of antituberculosis drugs, both for first-line and second-line drugs, serves as a guarantee of successful treatment.

Tuberculosis in Spain: An opinion paper.

This document is the result of the deliberations of the Committee on Emerging Pathogens and COVID-19 of the Illustrious Official College of Physicians of Madrid (ICOMEM) regarding the current situation of tuberculosis, particularly in Spain. We have reviewed aspects such as the evolution of its incidence, the populations currently most exposed and the health care circuits for the care of these patients in Spain. We have also discussed latent tuberculosis, the reality of extrapulmonary disease in the XXI century and the means available in daily practice for the diagnosis of both latent and active forms. The contribution of molecular biology, which has changed the perspective of this disease, was another topic of discussion. The paper tries to put into perspective both the classical drugs and their resistance figures and the availability and indications of the new ones. In addition, the reality of direct observation in the administration of antituberculosis drugs has been discussed. All this revolution is making it possible to shorten the treatment time for tuberculosis, a subject that has also been reviewed. If everything is done well, the risk of relapse of tuberculosis is small but it exists. On the other hand, many special situations have been discussed in this paper, such as tuberculosis in pediatric age and tuberculosis as a cause for concern in surgery and intensive care. The status of the BCG vaccine and its present indications as well as the future of new vaccines to achieve the old dream of eradicating this disease have been discussed. Finally, the ethical and medicolegal implications of this disease are not a minor issue and our situation in this regard has been reviewed.

Pengaruh Pemberian Terapi Obat Anti Tubekulosis Fase Intensif Terhadap Kadar Hemoglobin pada Penderita Tuberkulosis di Kota Kupang

ABSTRACT
 Background : Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis infection. According to World Health Organization Report (WHO), TB was ranked as the tenth highest cause of death in the world at 2016. During therapy, patients with active TB for category I were given Isoniazid, Rifampicin, Pyrazinamide and Ethambutol for 2 months which is the intensive phase and 4 months for continuation phase. Various studies have showed intensive administration of Anti Tuberculosis Drugs (ATD) have a relationship with hemoglobin levels either increasing or decreasing hemoglobin levels in tuberculosis patients.
 Objective : To find out the effect of ATD on hemoglobin levels in tuberculosis patients during the intensive phase of TB treatment in Kupang City
 Methods : This study was an interventional study using the Quasy-Experimental One Group Pretest and Post Test research design to determine effect of ATD on hemoglobin levels in tuberculosis patients during the intensive phase of TB treatment conducted in 11 Primary Health Care in Kupang City by taking capillary blood to measured hemoglobin level. The sampling technique used consecutive sampling and the sample size is 48 people of lung tuberculosis patients. The study was analyzed univariately and bivariately using paired-t test.
 
 Results : The results of data analysis of changes in hemoglobin levels before and after administration intensive phase of ATD showed significance value of p = 0.003 (p <0.05) with mean of ΔHb 0.88 gr/dl.
 
 Conclusion : There is an effect of administration intensive phase of anti-tuberculosis therapy to hemoglobin levels in tuberculosis patients in Kupang City

Plasma metabolomic and lipidomic alterations associated with anti-tuberculosis drug-induced liver injury.

Background: Anti-tuberculosis drug-induced liver injury (ATB-DILI) is an adverse reaction with a high incidence and the greatest impact on tuberculosis treatment. However, there is a lack of effective biomarkers for the early prediction of ATB-DILI. Herein, this study uses UPLC‒MS/MS to reveal the plasma metabolic profile and lipid profile of ATB-DILI patients before drug administration and screen new biomarkers for predicting ATB-DILI. Methods: A total of 60TB patients were enrolled, and plasma was collected before antituberculosis drug administration. The untargeted metabolomics and lipidomics analyses were performed using UPLC‒MS/MS, and the high-resolution mass spectrometer Q Exactive was used for data acquisition in both positive and negative ion modes. The random forest package of R software was used for data screening and model building. Results: A total of 60TB patients, including 30 ATB-DILI patients and 30 non-ATB-DILI subjects, were enrolled. There were no significant differences between the ATB-DILI and control groups in age, sex, smoking, drinking or body mass index (p > 0.05). Twenty-two differential metabolites were selected. According to KEGG pathway analysis, 9 significantly enriched metabolic pathways were found, and both drug metabolism-other enzymes and niacin and nicotinamide metabolic pathways were found in both positive and negative ion models. A total of 7 differential lipid molecules were identified between the two groups. Ferroptosis and biosynthesis of unsaturated fatty acids were involved in the occurrence of ATB-DILI. Random forest analysis showed that the model built with the top 30 important variables had an area under the ROC curve of 0.79 (0.65-0.93) for the training set and 0.79 (0.55-1.00) for the validation set. Conclusion: This study demonstrated that potential markers for the early prediction of ATB-DILI can be found through plasma metabolomics and lipidomics. The random forest model showed good clinical predictive value for ATB-DILI.

Granulomatous Mastitis: A Diagnostic Challenge

BackgroundGranulomatous mastitis (GM) is often found in reproductive-age women. These patients are treated by the administration ofantituberculosis drugs. It is difficult to determine the exact cause of GM cytologically and histopathologically. Various etiologies i.e.,tuberculosis, sarcoidosis, foreign bodies and immunological diseases may provide granulomatous inflammation features in thetissue. High-sensitivity tests such as PCR can help to detect the presence of Mycobacterium tuberculosis (MT) as one of possibleetiologic agent. Accurate diagnosis will improve the treatment quality thus a better quality of life. The aim of this study was todetermine whether the granulomatous mastitis patients who referred to the Department of Anatomic Pathology Faculty of MedicineUniversitas Sriwijaya/Dr. Moh. Hoesin Palembang Hospital were caused by MT.MethodsA descriptive observational study was performed. Thirty paraffin blocks of GM patients during the period of 1st October 2018 to 29thSeptember 2020 were collected. DNAs were extracted from tissue scrapings of the slides. Then, PCR analysis was conducted usinga specific primer IS6110 with around 200 bp PCR product.ResultsThe mean age of the patients was 40.8 years (range: 23-67 years). There were six samples (20%) of GM produced the expectedamplicon. However, only three of six samples morphologically consistent with tuberculosis.ConclusionGranulomatous inflammatory reactions in the breast are not only caused by tuberculosis. Further study is needed to determine theexact cause of this lesion. Despite high costs, PCR examination may become an alternative approach in determining the etiology ofGM.

Anti-tuberculosis drugs used in a directly observed treatment short course (DOTS) schedule alter endocrine patterns and reduce the ovarian reserve and oocyte quality in the mouse.

Tuberculosis is one of the major infectious diseases, with people of reproductive age group having a high risk of infection. The present study was designed to understand the consequences of anti-tuberculosis drugs (ATDs) used in DOTS (directly observed treatment short course) schedule on ovarian function. Adult female Swiss albino mice were orally administered with combinations of ATDs used in the DOTS schedule every day for 4weeks. At 2weeks after the cessation of ATDs administration, the endocrine changes and ovarian function were assessed in mice. Administration of ATDs to mice resulted in a prolonged estrous cycle, reduced ovarian follicle reserve, alteration in FSH, LH, and progesterone level, and decreased the number of ovulated oocytes. Further, the degree of fragmentation, degeneration, abnormal distribution of cytoplasmic organelles, abnormal spindle organisation, and chromosomal misalignment were higher in oocytes that were ovulated following superovulation. Blastocysts derived from ATDs treated mice had significantly lower total cell numbers and greater DNA damage. A marginal increase in the number of resorbed fetuses was observed in all the ATDs treated groups except in the multidrug resistance treatment group. Male progeny of ATDs treated mice had decreased sperm count and lower progressive motility, while female progeny exhibited a non-significant reduction in the number of oocytes ovulated. Theresults of this study suggest that ATDs can have significant adverse effects on the ovarian reserve, cytoplasmic organisation of oocytes, and can potentially cause transgenerational changes. The findings of the present study indicate ovarian toxicity of ATDs and warrant further research in the direction of identifying alternate drugs with minimal toxicity, and strategies to mitigate the ovarian toxicity induced by these drugs.

Endobronchial Tuberculosis: Diagnosis and Treatment Approach

Endobronchial tuberculosis (EBTB) is defined as tuberculosis (TB)infection of the tracheobronchial tract. Tracheal and bronchial involvement from TB infection was first reported by Morten in 1698. Endobronchial tuberculosis is a form of TB that is difficult to diagnose because the lesions are frequently undetectable by sputum examination and chest X-ray alone. Endobronchial tuberculosis is present in 10-40% of active TB patients and more than 90% of cases are accompanied by bronchial stenosis of various degrees. The main goal of therapy in active EBTB is to eradicate Mycobacterium tuberculosis in the tracheobronchial tract and further prevent stenosis. Complications of EBTB apart from airway stenosis are atelectasis, haemoptysis and shortness of breath accompanied by wheezing even after administration of anti-tuberculosis drugs (ATD).

Severely ill patients with tuberculosis: the option to reduce mortality and optimize management with the help of step therapy and the usage of infusion forms of anti-tuberculosis drugs

Background. A doctor often has to answer the question whether it is sufficient to treat tuberculosis (TB) exclusively with the oral forms of anti-tuberculosis drugs (ATD). In general, the answer is yes, if the absorption of drugs and their delivery to the affected organs is not impaired. However, drug absorption is often impaired due to hypoalbuminemia, TB of the gastrointestinal tract or central nervous system, concomitant diseases of the digestive system, alcoholism, hyperthyroidism, diabetes, or in the elderly patients.
 Objective. To evaluate the feasibility of using infusion forms of ATD.
 Materials and methods. Review of current guidelines.
 Results and discussion. The advantages of exclusively oral administration of ATD include convenience, low cost, the possibility of usage in an outpatient setting, whereas the main disadvantage is that it is not always possible to create the required concentration of ATD in blood plasma. In turn, the advantages of intravenous ATD include the creation of maximal concentrations in blood plasma and foci of infection, fewer side effects in the digestive system, patients’ awareness of the importance of treatment, whereas disadvantages are high cost and low adherence to treatment. The use of part of the ATD as a step therapy (course of intravenous infusions with subsequent transition to oral administration) allows to create the maximal concentration of active substances in blood plasma and affected organs at the beginning of treatment, to provide better cost/effectiveness ratio in comparison to previously listed regimens, and to increase the treatment adherence without compromising the quality of life of patients. The additional cost of intravenous ATD delivery devices is the main disadvantage. Criteria for the transition from the infusions to oral administration are the elimination of bacterial excretion, obtaining a stable positive dynamics of the clinical condition, elimination of the causes of the need for intravenous treatment (normalization of swallowing function, elimination of malabsorption). Indications for step therapy include the severe forms of TB, severe disorders of the central nervous system and gastrointestinal tract, the presence of severe comorbidities, pre- and postoperative periods, mental disorders, side effects of 3rd-4th degree in case of oral ATD intake. The duration of the infusion course is determined individually, but in average it is about 1-2 months. Such drugs as rifampicin, isoniazid, ethambutol, levofloxacin, moxifloxacin, linezolid, and carbapenems exist in the infusion form.
 Conclusions. 1. Infusion of ATD as a part of step therapy can improve the quality of treatment of TB patients. 2. Criteria for the transition from infusions to oral administration are the elimination of bacterial excretion, obtaining a stable positive dynamics of the clinical condition, elimination of the causes of the need for intravenous treatment. 3. The duration of the infusion course is determined individually (in average – 1-2 months).

SWELLING OF THE SUBCUTANEOUS INTERSTITIUM UNDER THE INFLUENCE OF ISONIAZID AND DIFFERENT PH LEVELS

The article deals with the issues of interstitial conductivity for isoniazid and saline solution with different pH levels. Experimental studies were conducted to substantiate and explain the mechanisms of effectiveness of indirect endolymphatic drug administration. At the present stage, lymphotropic administration of anti-tuberculosis drugs occupies a worthy place in the complex therapy of patients with pulmonary and extrapulmonary tuberculosis. Lymphotropic therapy is an etio-pathogenetic method of treating patients and consists of regional subcutaneous injections of medicinal solutions with the use of lymphotropy factors, among which it is important to create an active functioning of the interstitial zones of lymphotropic administration, which determines the flow of drugs into the lymphatic channel. The influence of acidification and alkalinization of the medium on the hydrophilicity of the interstitium of the subcutaneous tissue of the parasternal zone, armpit, and interdigital spaces was studied. As incubation solutions, saline solution with pH 6.9, pH 7.4, pH 6.0 and 10% isoniazid solution (10%H) were used. It was found that the interstitial subcutaneous tissue of the lymphotropic injection zones is characterized by different intensity of swelling, which is probably due to the morphological features of the fiber, different content of loose connective and adipose tissues in it. The swelling coefficient is regulated by the pH level of incubation solutions and the chemical structure of the administered lymphotropically medicinal substance. Features of interaction between interstitial lymphotropic points and the drug should be taken into account when prescribing indirect endolymphatic therapy schemes. It is likely that the pH of the administered solutions must be maintained at the level of the physiological norm (7.4). Isoniazid in the lymphotropic points creates a depot that is more pronounced in the parasternal region.

Effect of Iron Supplementation in Anti-Tuberculosis Drug Treatment on Interferon-γ Level in Tuberculosis Spondylitis Patients

Tuberculosis (TB) is still one of the major health problems in the community. Micronutrients, including iron, are crucial in the body's defense mechanism. Iron modulates the activation of IFN-γ, which in turn will activate the macrophages. This study explores the effect of iron supplementation given with anti-tuberculosis drug therapy on the IFN-γ level in tuberculosis spondylitis patients. This was a single-blind randomized control trial study at Dr. Hasan Sadikin General Hospital Bandung, from December 2018 to March 2019, using the consecutive sampling approach. Thirty-four respondents with category 1 TB spondylitis and an sTfR level of> 21.7 pg /µL were recruited and randomized into control and experimental groups. The control group (n=17) was treated with 2 RHZE for 2 months while the experimental group (n=17) received 2 RHZE and iron tablet for 2 months. An increase in the IFN-γ level of the experimental group was observed from an average of 21.7 pg/ml before therapy to an average of 72.39 pg/mL after therapy. Meanwhile, the IFN-γ level in the control group increases from an average of 22.5 pg/mL to an average of 35.35 pg/mL. This difference was statistically significant based on the analysis using the independent t-test (p-value <0.05). Therefore, the administration of anti-tuberculosis drugs with the addition of iron can increase the body's immune response, which is indicated by the increasing level of IFN-γ.

Analisis Pengaruh Obat Antituberkulosis Terhadap Nilai Sgpt dan Sgot pada Pasien Penderita Tuberkulosis Paru

Tuberculosis (TB) is a direct infectious disease caused by Mycobacterium tuberculosis. Anti-tuberculosis drugs have a hepatotoxic effect that causes extensive liver injury and harvesters. The parameter to determine the presence or absence of liver damage is to look at SGPT and SGOT levels. The purpose of this study was to determine the effect of drugs on SGPT and SGOT values based on age and sex classification. The method is carried out with a retrospective approach. The results showed that the effect of drugs on the value of SGPT with a high value of> 35 as much as 6.25%, on the value of SGOT with a high value> 35 as much as 12.5%. Whereas at the age of 56-65 years the SGPT value was 2.5% and SGOT was 3.75%, at the age of 17-25 years the SGOT value was 3.75%. sex with a high SGPT score of 5%. While the SGOT value is equal to 6.25%. Then it can be concluded that the administration of anti-tuberculosis drugs to the value of SGPT and SGOT has an effect on the value of SGPT and SGOT based on age is productive age which is 15-49 years whereas based on gender is men.

Pleural Space Complications from Tuberculous Empyema: A Case Report and Short Literature Review

Tuberculous empyema (TE) is an uncommon form of pleural tuberculous (TB). Although the incidence of TE has significantly decreased, it still threatens public health. Patients with TE experience a protracted illness and significant morbidity and mortality risk. Male sex is a significant risk factor for TE. Herein, we report an adult case of TE admitted to a tertiary care hospital of Iran with clinical characteristics, treatment modalities, and outcomes of this disease. The duration of illness and duration of chest tube drainage equaled 7 months and 48 days, respectively. Our patient required surgery despite the administration of antituberculosis drugs and chest tube drainage. Due to the presence of parenchymal lesions, bronchopleural fistula, and failure of lung re-expansion after chest tube insertion, the patient required decortication with the closure of the bronchopleural fistula and additional thoracoplasty. In the case presentation, we emphasize difficulties encountered in the treatment of such patients.

Effectiveness of the treatment of generalized tuberculosis in HIV-infected patients

Abstract. The treatment of tuberculosis in HIV-infected persons is a complex task and often requires intensive therapy with intravenous administration of antituberculosis drugs, especially in generalized forms, malabsorption, presence of enteropathy, hepatitis B and C, severe condition. One of the dangerous forms of tuberculosis in HIV-infected people is meningeal tuberculosis. In these cases, the effectiveness of treatment for HIV-positive patients depends on timely detection, diagnosis of resistance to antituberculosis drugs, presence of other opportunistic diseases. Here is an example of treating a HIV-positive patient with miliary tuberculosis with lung damage, lymph nodes and meningeal tuberculosis caused by a multiresistant strain of tuberculosis. The treatment was performed taking into account drugs that cross the blood-brain barrier, drug sensitivity test, immunosuppression and the presence of malabsorption. Timely intensive therapy with intravenous administration of medications for medical sensitivity allowed to obtain positive dynamics and cure the patient in the short term.

ANTIOXIDANT EFFECTS OF ADEMETIONINE UNDER ADMINISTRATION OF ANTITUBERCULOSIS DRUGS IN TOXIC DOSES TO RATS

The article presents the results of the experimental toxicological study on the use of ademetionine as an antioxidant defense in rats under administration of anti-tuberculosis drugs.

Exposure to first line anti-tuberculosis drugs in prepubertal age reduces the quality and functional competence of spermatozoa and oocytes in Swiss albino mice

Prepubertal Swiss albino mice of both sex were administered with first-line anti-tuberculosis drugs (ATDs) viz; rifampicin, isoniazid, pyrazinamide, streptomycin and ethambutol intraperitoneally, for 4 weeks. Two weeks after the completion of treatment, male mice were sacrificed to collect caudal spermatozoa and female mice were superovulated with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) to collect metaphase II (MII) oocytes from oviduct. Administration of ATDs not only decreased the count, motility and, nuclear maturity and also, increased the head abnormalities, mitochondrial damage and DNA damage in epididymal spermatozoa. Reduction in number of ovulated oocytes, increased degeneration rate and altered distribution pattern of cytoplasmic organelles was observed in oocytes of female mice. Presence of ATDs in in vitro maturation (IVM) medium increased abnormalities in meiotic resulted in abnormal spindle organization (except ethambutol) without affecting nuclear maturation. In conclusion, the result of this study indicates that ATDs have considerable adverse effects on the functional competence of male and female gametes, however, with varied degree of toxicity.

SEORANG WANITA DENGAN TB PARU KASUS BARU DAN TB EKSTRA PARU MULTIPLE

Background; Tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis (Acid-Fast Bacilli/AFB) that still be a world burden. Extra Pulmonary TB occurred when there were infection and development of Mycobacterium tuberculosis outside lungs, which about 10% cases was Milliary TB. There will be reported case with Lung TB New Case coexistence with Multiple Extra Pulmonary TB. Case; A female, 39 y.o., came to the Soetomo General Teaching Hospital with chief complaint body weakness since 12 months ago following with cough, decrease of appetite, decrease of body weight, low grade fever, and night sweating. The cough was on and off, not productive, and didn`t improve with usual therapy. Her other complaint were painless mass at the left supraclavicular area, swollen and pain at the right knee, and pain at the backbones. Patient had subsequently given Anti Tuberculosis Drugs (ATD) with Streptomycin injection based on clinical judgement. Discussion; In several cases, Primary Focus as the result of AFB infection in the lung can spread to the other organs. The diagnosis had been made from comprehensive summary of clinical aspects, radiology data, laboratory data, and Histopathology data. Consideration of ATD choice based on grouping of TB diseases (Pulmonary/Extra Pulmonary), severity level of Extra Pulmonary TB and clinical judgement Conclusion; Had reported female patient diagnosed with Lung TB New Case, Osteomyelitis TB, Spondilitis TB, and Lymphadenitis TB. Based on therapeutic evaluation there was improvement condition of the patient after administration of ATD and injection of Streptomycin.

Tuberculosis Management in Renal Transplant Recipient

Background: Tuberculosis (TB) is a major global health problem and South-East Asia was the leading contributor of TB cases globally. Treatment regimen of TB for an individual patient depends on multiple factors, and one of them was patient’s comorbidities. Comorbidities such as renal failure or concurrent use of immunosuppressant drugs post renal transplantation will influence pharmacological aspect of anti-tuberculosis drugs.Case: A 38-year-old male with a history of chronic renal failure who had undergone routine hemodialysis was diagnosed with pulmonary tuberculosis and was scheduled for a renal transplantation procedure. During the administration of anti-tuberculosis drugs in this patient, the physician mustconsider the kidney function, and possible drug interactions between anti-tuberculosis drugs especially rifampicin with immunosuppressant drugs used after renal transplantation. The initialregimen used in this patient was RHE which was followed by RH, but after using immunosuppressant drugs, rifampicin was replaced with moxifloxacin to avoid suboptimal effect of immunosuppressant drugs to prevent donor rejection, which is the biggest contributor ofmortality in transplant recipients in the first year post-transplantation.

Anti-TB Drug for Tuberculosis Spondylitis

Tuberculosis spondylitis, or spinal tuberculosis, is a disease that occurs throughout the world. Conservative therapy that is given to patients with spinal tuberculosis actually gives good results, but in certain cases, it requires surgery and rehabilitation therapy. The incidence of tuberculous spondylitis varies worldwide and is usually associated with the quality of available public health service facilities as well as the social factors in the country. Currently, tuberculosis spondylitis is a major source of morbidity and mortality in underdeveloped countries, especially in Asia, where malnutrition and population still remains a major issue. The goals of therapy in tuberculosis spondylitis are eradication of infection or at least to prevent neurological deterioration, and prevention or correction of a deformity or neurological deficit. Administration of anti-tuberculosis drugs is a major therapeutic principle in all cases including spinal tuberculosis. Early administration of anti-tuberculous drugs can significantly reduce morbidity and mortality.

Anti-TB Drug for Tuberculosis Spondylitis

Tuberculosis spondylitis, or spinal tuberculosis, is a disease that occurs throughout the world. Conservative therapy that is given to patients with spinal tuberculosis actually gives good results, but in certain cases, it requires surgery and rehabilitation therapy. The incidence of tuberculous spondylitis varies worldwide and is usually associated with the quality of available public health service facilities as well as the social factors in the country. Currently, tuberculosis spondylitis is a major source of morbidity and mortality in underdeveloped countries, especially in Asia, where malnutrition and population still remains a major issue. The goals of therapy in tuberculosis spondylitis are eradication of infection or at least to prevent neurological deterioration, and prevention or correction of a deformity or neurological deficit. Administration of anti-tuberculosis drugs is a major therapeutic principle in all cases including spinal tuberculosis. Early administration of anti-tuberculous drugs can significantly reduce morbidity and mortality.