Q: I am 48 years old, suffering from acute pain in the left leg accompanied by body ache from the last 3.5 months. After a MRI, I was diagnosed to be suffering from TB in the sacroiliac joint. My physician told me to take AKT 4 - paradoxin 10 mg, Liv 52, Lyser and streptomycin. Since it was very painful for me to bear the pain of the injections, after 10 injections, I requested the doctor for an alternative. He replaced streptomycin with ofloxacin 200 mg. I am apprehensive about the fact whether injections are more effective in curing the disease. I do not want to take injections but I am concerned if ofloxacin will be equally effective to cure the disease?

A:I presume that the TB in your case is limited to bony structures and is not compressing the spinal cord since in the latter case surgical intervention may be required. The treatment of uncomplicated vertebral tuberculosis is exactly the same as tuberculosis of the lungs as per globally accepted guidelines issued by the National Institute of Clinical Excellence and WHO. There is widespread misconception that one needs to give more medicines in spinal tuberculosis compared to lungs TB. The treatment involves the administration of four anti-TB medicines and one vitamin i.e. isoniazid, rifampicin, ethambutol, pyrizinamde and vitamin B-6. AKT-4 is the brand name of a product that contains these anti-TB medicines but not vitamin B-6. However CX-5 brand contains all the above ingredients. CX-5 needs to be taken for two months. After two months, it is necessary to use only three anti-TB medicines and vitamin B-6 i.e. isoniazid, rifampicin, ethambutol and vitamin B-6. CX-4 contains these four medicines. It needs to be taken for four additional months. In the meantime patient should be monitored periodically. In few cases, the treatment may need to be extended to nine months. Lyser-D is an irrational, unscientific combination of diclofenac and serratiopeptidase. Such a combination is not permitted to be sold in any advanced country like US, Britain etc. Besides diclofenac has adverse effect on liver. Some anti-TB medicines (isoniazid, ethambutol, rifampicin) have also side effects that involve liver. Hence Lyser-D should not be used with anti-TB drugs since together they may damage the liver. If at all pain is severe, one can use a mild painkiller like ibuprofen (such as Brufen) 400 mg 1-2 times daily on SOS basis. Unless TB germs are found to be resistant to front line drugs, listed above, it is not necessary to take either streptomycin injections or ofloxacin. These should be kept in reserve. Liv-52 has no scientifically proven role either in the treatment of spinal tuberculosis or prevention of side effects. The National Commission on Macroeconomics and Health has described Liv-52 as useless. In fact the Supreme Court has banned the prescription of non-allopathic medicines (herbal, Ayurvedic, Unani, Sidhha etc.) by doctors of modern medicine since they are not taught and trained to properly understand and use them.