Antibiotic Treatment of Urogenital Tuberculosis

Introduction: Tuberculosis (TB) is a communicable disease that is a major cause of ill health, which typically affects the lungs (pulmonary TB) but can also affect other sites (extrapulmonary TB). Urogenital TB (UGTB) is the second-third most common form of TB. The anti-TB therapy for UGTB has some special features. Materials and methods: The present chapter is based on a narrative review of literature with keywords “urogenital tuberculosis,” “prostate tuberculosis,” “kidney tuberculosis,” and “treatment of tuberculosis.” Data were obtained from articles published in Russian and in English from journals indexed in PubMed, Google scholar, and eLibrary. Results: Without treatment, two-thirds of affected patients will die, and the remaining one-third is likely to suffer from chronic sequelae. New oral TB drugs that are more active and less toxic are desperately needed to build new regimens that can be disseminated rapidly and successfully to the many people affected by drug-sensitive as well as drug-resistant MDR-TB in low-resource settings. The main principles of anti-TB chemotherapy are continuity, controllability, and follow-up of the treatment. Neglect of these principles leads to the development of drug-resistant Mtb and relapse of TB. Treatment of TB requires a combination of antimicrobials to ensure efficacy and reduce the likelihood of acquiring resistance and of treatment failure. Conclusions: UGTB is difficult for suspicion, for diagnosis, and for therapy. Even if we have a case of early diagnosed UGTB, nonoptimal therapy may result in over-fibrosis, scaring, and strictures of urinary tract, which, again, are an indication for surgery.