How Long Should A Child Be Treated For Bone And Joint TB?

Posted on Wed, 30 Mar 2016

Question: Are we doing the correct procedure? Some doctor recommends that we need to go for 9-12 months of medication & pediatrician refer us to take for 6 months only. We are fearing about not to spread anywhere & side effects of the medicine. Doctor suggesting to take liver test after the 6 moths course completion. your advise is much needed. Thanks

Answered by Dr. Sumanth Amperayani (2 hours later)

Brief Answer:
Give 9-12 months of treatment

Detailed Answer:
Hi...I have completely read through the history you have provided. My suggestions -

1. The treatment for bone and joint TB should be for 9-12 months period. The initial intensive phase can be for 2 months and the extended continuation phase can be for another 10 months. I would do this if I were your kid's pediatrician.

2. The treatment is hing on in the right direction and the drug combinations are Good.

3. You should be giving high protein diet. Give him 3 boiled eggs per day along with pulses. There are no food restrictions.

4. If you complete the course of 12 months without missing even a single day of medication then it is unlikely to spread elsewhere in the body.

5. You should take a liver function test after 6 months of treatment as drugs used for TB can sometimes cause hepatotoxicity.

Hope you found the answer helpful.

Let me know if I can assist you further.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Sumanth Amperayani (25 minutes later)

Thanks you so much Doctor.. got your positive response on this.

TB is on the tissue.. Bones are not infected & we checked this through MRI & whole body bone scan.. In this case, how many months we have to go for treatment.

How do we ensure that mycobacteria is completely eradicated after the course completion..

Answered by Dr. Sumanth Amperayani (41 minutes later)

Brief Answer:
In that case 6 months treatment would do

Detailed Answer:
Hi....sorry to have misunderstood your question. If bone and joint are not involved then the treatment need to be only total 6 months. The intensive phase should be 2 months followed by continuation phase of another 4 months.

To ensure that mycobacteria are completely eradicated we need to do a biopsy of the same site where it was previously done.

But usually we do not do this. We as clinicians go by our clinical judgement based on treatment response and well being of the kid like good appetite and weight gain and symptomatic relief.

Regards - Dr. Sumanth

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Above answer was peer-reviewed by : Dr. Naveen Kumar