March 04, 2011.
FRIDAY, March 4 (HealthDay News) -- Effective bactericidal concentrations (EBCs) of three antitubercular drugs are found in osseous tissues around spinal tuberculosis foci, except for an area of osseous tissues 4 mm surrounding the sclerotic wall, according to a study published online Feb. 9 in Spine.
Peng Liu, M.D., from Southern Medical University in Guangzhou, China, and colleagues examined computed tomography images from 38 patients with spinal tuberculosis and assigned them to sclerotic and non-sclerotic groups. Patients underwent 10 months of chemotherapy and underwent surgery after four weeks of chemotherapy. Samples of serum, ilium, and pathological vertebrae tissues, including foci and sclerotic wall (where applicable), were analyzed. Abnormal osseous tissue samples were collected from within 4 mm of foci (region I) and more than 4 mm from foci (region II). The concentration levels of isoniazid, rifampin, and pyrazinamide and their metabolites were measured using high-performance liquid chromatography.
The investigators found that, in the non-sclerotic group, all three drugs achieved EBC in region I. Isoniazid and rifampicin concentrations were higher than the EBC; the pyrazinamide level was five times the minimal inhibitory concentration in region II of abnormal osseous tissues and the ilium. Foci in the non-sclerotic group contained traces of the drugs and their metabolites. In the sclerotic group, no drug achieved EBC in region I and only pyrazinamide was found in the foci.
"In order to enhance the antitubercular drug treatment, the osseous tissues within 4 mm surrounding the sclerotic wall should be sectioned during the surgery," the authors write.
http://www.doctorslounge.com/index.php/news/pb/18340
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