Treatment of chest wall tuberculosis with transdermal ultrasound-mediated drug delivery

Abstract

Chest wall tuberculosis (TB) is an endemic disease with a large number of variants. The condition affects numerous parts of the body and can penetrate the skin to form chronic open ulcers. Current treatment methods include oral anti-TB drugs and surgery. However, conventional drug treatments are not effective due to the difficulty in achieving an effective local concentration, and certain patients are unable to tolerate surgery. The recurrence rate for chest wall TB is high following surgery, and may result in the prolonged healing of wounds in certain patients, as well as chronic sinusitis and fistula formation. To identify a safe, simple, less invasive and more clinically effective treatment method, the present study investigated transdermal ultrasound-mediated anti-TB drug delivery. A total of 186 patients were selected and randomly divided into transdermal ultrasound, surgery and oral anti-TB drug only groups. Rifampicin was the drug delivered by transdermal ultrasound. The cure and efficiency rates were shown to be 87.10 and 93.55%, respectively, in the ultrasound treatment group. No statistically significant difference was observed in the cure rates between the transdermal ultrasound and surgery groups; however, a statistically significant difference was identified in the cure rates between the transdermal ultrasound and oral anti-TB drug only groups. Therefore, transdermal ultrasound technology was shown to deliver anti-TB drugs quickly and directly, which resulted in a high local concentration of the drug, overcoming the problem of obtaining an effective local drug concentration. The observations demonstrated that transdermal ultrasound-mediated drug delivery is an effective method by which to control TB, particularly when compared with traditional oral anti-TB therapy and surgery.

<p>Preoperative Ultra-Short-Course Chemotherapy Combined with Surgery for the Treatment of Chest Wall Tuberculosis</p>

“…11,13 The treatment for chest wall TB includes simple TB drug chemotherapy, lesion puncture and drainage, and surgical treatment. 14,15 It is usually difficult to completely eliminate most cases of chest wall TB by chemotherapy alone. Hence, surgical removal of the focus is essential.…”

“…11 , 13 The treatment for chest wall TB includes simple TB drug chemotherapy, lesion puncture and drainage, and surgical treatment. 14 , 15 …”