From the Department of Medicine, Section of Infectious arid Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
Abstract: (5540 Views)
From 1986-1989, sixteen patients suffering from TB meningitis aged
12-58, with CSF smear or culture positive for Mycobacterium tuberculosis
were hospitalized and treated with rifampin (RIF) , isoniazid (INH) , pyrazinamide
(PZA) and ethambutol (ETB) for nine months.
In all patients, ETB and PZA were withdrawn after three months and
INH and RIF were continued for the next six months. 81.2 percent of patients
were in stages 2 and 3 of this illness, and steroids were added to their
treatment regimes. In two patients whose liver enzymes and blood uric acid
levels increased during the second week of therapy, INH was discontinued
temporarily and PZA was replaced with streptomycin. In the remaining
patients, side effects of drugs and central, peripheral and other complications
were trivial. Mortality rate was 25%, follow-up of the patients
continued for 12-24 months.
According to the mortality and morbidity of classic 12-18 months
therapy with three drugs and results obtained in this study, treatment with
four drugs for nine months showed some advantages to the other protocols.
We look forward to finding more documents and similar studies from
other centers. Confirmation of results of this study could be a suggestion for
short-course therapy in TB meningitis, and this is the first report of
short-course therapy in TB meningitis from Iran.