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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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79 Years. Have Spine TB. Unable To Walk. Recommended AKT 4, Switched To AKT 3, Advised Bed Rest. Right Treatment?

My father aged 79, weight about 70 kg., is suffering from 'spine TB. Doctor has recommended to take AKT 4, and for the last four and half months. Now doctor has switched on to AKT 3, still he is not able to walk. Doctor has advised strict bed rest.
My question is whether this treatment is in order. Second when he will be able to walk. Whether any other medicine is to be given
Thu, 19 Sep 2013
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General & Family Physician 's  Response
HI and thank you so much for this query.

I am so sorry to hear about the spinal TB that your father has and the resulting complication of being unable to move.

From the information you have provided, this treatment plan is the classical treatment for tuberculosis. The truth is that they change from country to country according to national guidelines. Doctors simply apply the recommendations handed down to them in this case. This is exactly how I would have treated a similar patient in my clinic. This treatment would again be modified towards the end to a two regimen drug plan.

The goal of treatment here is to stop the progression of the disease. Restoring most functions is always very difficult and in most cases not fully recovered. We can only hope that he regains some of his lost functions but the hopes on this are largely determined by how much damage the disease has caused already.

I would have suggested that he gets pyridoxine tabletes as prophylaxis for isoniazide toxicity given his age. Check whether the doctor considered this as well. this is simply for the comfort during treatment and doesn't really change the outcome if no side effects results in abandonment of treatment.

I hope this addresses your query fully. If you have any further questions, please feel free to come back to us. Thanks
Dr. Ditah, MD
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79 Years. Have Spine TB. Unable To Walk. Recommended AKT 4, Switched To AKT 3, Advised Bed Rest. Right Treatment?

HI and thank you so much for this query. I am so sorry to hear about the spinal TB that your father has and the resulting complication of being unable to move. From the information you have provided, this treatment plan is the classical treatment for tuberculosis. The truth is that they change from country to country according to national guidelines. Doctors simply apply the recommendations handed down to them in this case. This is exactly how I would have treated a similar patient in my clinic. This treatment would again be modified towards the end to a two regimen drug plan. The goal of treatment here is to stop the progression of the disease. Restoring most functions is always very difficult and in most cases not fully recovered. We can only hope that he regains some of his lost functions but the hopes on this are largely determined by how much damage the disease has caused already. I would have suggested that he gets pyridoxine tabletes as prophylaxis for isoniazide toxicity given his age. Check whether the doctor considered this as well. this is simply for the comfort during treatment and doesn t really change the outcome if no side effects results in abandonment of treatment. I hope this addresses your query fully. If you have any further questions, please feel free to come back to us. Thanks Dr. Ditah, MD