Tuberculosis Meningitis Medical Treatment and Therapy

      Tuberculosis Meningitis Medical Treatment and Therapy by three different components: administration of anti TB drugs, modulating the immune response and management or increased intracranial pressure treatment and therapy. Here are the guidelines and anti-TB drug delivery dosage for infant and children both first-line and second-line.

Guideline Anti-TBC Drug for Infant and Children

       A study by Thwaites et al. randomly assigned 61 adult patients (age> 14 years) tuberculous meningitis. Patients received standard antituberculosis therapy alone or in combination antituberculosis therapy with ciprofloxacin 750 mg every 12 hours (n = 16), levofloxacin 500 mg every 12 hours (n = 15), or gatifloxacin 400 mg every 24 hours (n = 15) for 60 days first. Penetration of levofloxacin in the cerebrospinal fluid is greater than gatifloxacin and ciprofloxacin, with p <0.001.

Secondline Anti-TBC Drug for Infant and Children

     Conclusions This study is tuberculous meningitis patients likely to benefit from therapy fluoroquinolone visible from exposure-response relation associated with improved outcomes. Fluoroquinolone add antituberculosis activity on standard therapy, but should be started as soon as possible before the comma to get a better outcome. Tuberculous meningitis is a disease of extrapulmonary tuberculosis that are fatal and must be promptly diagnosed and treated. Tuberculous meningitis patients most likely to benefit from fluoroquinolone therapy.

        While the recommendations of the World Health Organization (WHO) for first-line TB drugs is as follows:

WHO Anti-TBC Drug First Line

        Fixed-dose drug combination (FDC) is a medicine that contains two or more types of drugs in a single tablet or capsule. The advantage of the use of the FDC is to lower the risk of the formation of drug resistance and medication errors are less because only a few drugs that need to be prescribed. Children over 8 years of age weighing more than 30 kg can be given a standard four-drug FDC or FDC that contains four types of standard TB drugs used in adult patients during the intensive phase (two months) of therapy

        Ethambutol hard to get into the cerebrospinal fluid so as to regimens of TB meningitis is usually replaced with ethionamide or streptomycin. Isoniazid 15-20 mg / kg / day (maximum daily dose 400 mg). Rifampicin is 15-20 mg / kg / day (maximum daily dose 600 mg). Ethionamide 15-20 mg / kg / day (maximum daily dose of 1 g). Pyrazinamide 30-40 mg / kg / day (maximum daily dose of 2 g). TB meningitis is also an indication of the use of corticosteroids, which is usually used is given a dose of oral prednisone 2 mg / kg / day (maximum 60 mg per day) for four weeks in addition to anti-TB drugs and done tapering off after two weeks (a total of 6 weeks of corticosteroid use )