SETTING: The British Thoracic Society and the American Thoracic Society advise 12 months treatment for tuberculous meningitis, with at least isoniazid (H), rifampicin (R) and pyrazinamide (Z). OBJECTIVE: To establish whether a 6-month treatment regimen for tuberculous meningitis is equally as effective as longer treatment. METHOD: Medline search for papers published between 1978 and 1999. INCLUSION CRITERIA: study populations of patients with tuberculous meningitis in whom the diagnosis was confirmed with clinical, cerebrospinal fluid and epidemiological findings; a treatment regimen with at least HRZ and at least 12 months of follow-up after the completion of treatment. OUTCOME MEASURE: the number of relapses. RESULTS: There were four 6-month treatment regimens (G6) and seven longer treatment regimens (G>6); 160/197 (81%) patients completed the 6-month treatment regimens, while 577/675 (85%) completed the longer-term regimens. The clinical stage of patients in the G6 group was poorer than in the G>6 group. Relapse occurred in two out of 131 (1.5%) G6 and in 0 out of 591 G>6 patients. CONCLUSION: Although no studies have compared 6-month treatment regimens with longer treatment, it can be concluded on the basis of this literature review that 6-month treatment is sufficient for tuberculous meningitis with fully susceptible mycobacteria.
SETTING: The British Thoracic Society and the American Thoracic Society advise 12 months treatment for tuberculous meningitis, with at least isoniazid (H), rifampicin (R) and pyrazinamide (Z). OBJECTIVE: To establish whether a 6-month treatment regimen for tuberculous meningitis is equally as effective as longer treatment. METHOD: Medline search for papers published between 1978 and 1999. INCLUSION CRITERIA: study populations of patients with tuberculous meningitis in whom the diagnosis was confirmed with clinical, cerebrospinal fluid and epidemiological findings; a treatment regimen with at least HRZ and at least 12 months of follow-up after the completion of treatment. OUTCOME MEASURE: the number of relapses. RESULTS: There were four 6-month treatment regimens (G6) and seven longer treatment regimens (G>6); 160/197 (81%) patients completed the 6-month treatment regimens, while 577/675 (85%) completed the longer-term regimens. The clinical stage of patients in the G6 group was poorer than in the G>6 group. Relapse occurred in two out of 131 (1.5%) G6 and in 0 out of 591 G>6 patients. CONCLUSION: Although no studies have compared 6-month treatment regimens with longer treatment, it can be concluded on the basis of this literature review that 6-month treatment is sufficient for tuberculous meningitis with fully susceptible mycobacteria.
Authors: R Bryan Rock; Michael Olin; Cristina A Baker; Thomas W Molitor; Phillip K Peterson Journal: Clin Microbiol Rev Date: 2008-04 Impact factor: 26.132
Authors: Surendra K Sharma; H Ryan; Sunil Khaparde; K S Sachdeva; Achintya D Singh; Alladi Mohan; Rohit Sarin; C N Paramasivan; Prahlad Kumar; Neeraj Nischal; Saurav Khatiwada; Paul Garner; Prathap Tharyan Journal: Indian J Med Res Date: 2017-04 Impact factor: 2.375