Comparison of c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values in pulmonary tuberculosis and tb spondylitis patients before and after anti-tuberculosis therapy

Background: The principle of anti-tuberculosis (TB) drug treatment in TB spondylitis is based on pulmonary TB guidelines, but the treatment duration still varies because there are no definite guidelines in treatment evaluation. C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) are proposed as established biomarkers in evaluating therapy in TB infection due to its inexpensiveness and practicality. Study which compare the effectiveness of anti-TB drug between pulmonary TB and TB spondylitis using CRP and ESR is still rare. Objective: To compare of the effectiveness of anti-TB drug in patients with pulmonary TB and TB spondylitis assessed by CRP levels and ESR. Method: This is an analytical study with a prospective cohort design conducted at the Dr. M. Djamil General Hospital Padang, UNAND Hospital, Pulmonary Hospital West Sumatra, Air Tawar Health Center, and Pemancungan Health Center from January 2024 to June 2025. All patients suffering from TB spondylitis and pulmonary TB who met the inclusion and exclusion criteria were included. Evaluation of the effectiveness of treatment is carried out by examining CRP and LED after being given anti-TB drug for 2 months. Results: There were 22 subjects divided into pulmonary TB and TB spondylitis groups. This study found a significant decrease in CRP levels in pulmonary TB patients (72.77±23.38 vs 38.17±17.88; p=0.000), and also CRP levels in TB spondylitis patients (94.27±39.65 vs 42±17.14; p=0.001) before and after anti-TB drug administration. A significant decrease was also found in ESR in pulmonary TB patients (60.81±36.83 vs 31.45±20.86; p=0.003) and TB spondylitis (72±30.30 vs 39.9±21.31; p=0,000) before and after anti-TB drug administration. Analysis showed no difference in the effectiveness of anti-TB drug in patients with pulmonary TB and TB spondylitis evaluated using CRP (p=0.159) and ESR (p=0.774). Conclusion: This study found favorable anti-TB drug effectiveness in pulmonary TB and TB spondylitis after 2 months of administration, which was assessed using CRP and ESR.