Clinical outcomes among patients with tuberculous meningitis receiving intensified treatment regimens.

Journal Article (Journal Article)

SETTING: National Center for Tuberculosis and Lung Diseases (NCTLD), Tbilisi, Georgia.OBJECTIVE: To determine clinical outcomes of patients with tuberculous meningitis (TBM) treated with an intensified regimen including a fluoroquinolone (FQ) and an injectable agent.DESIGN: Prospective cohort of patients aged ≥16 years initiating treatment for TBM at the NCTLD from January 2018 to December 2019. Treatment outcomes and neurologic disability at 1, 6 and 12 months after treatment initiation were assessed.RESULTS: Among 77 patients with median follow-up time of 363 days (IQR 269-374), 97% received a FQ, 62% an injectable agent, 44% linezolid and 39% a carbapenem. Fifty-seven patients (74%) successfully completed treatment, 2 (2.6%) had treatment failure, 6 (7.8%) died, and the remainder (12%) were lost to follow up. Among 11 patients treated for multidrug-resistant TBM, the median follow-up time was 467 days and one patient (8%) died. Regarding neurologic outcomes, 14/76 (18%) patients had Modified Rankin Scores of 0 at baseline, improving to 85% (56/66) and 94% (47/50) at 6 and 12 months, respectively.CONCLUSION: Intensified multidrug treatment regimens including a FQ and an injectable agent in all patients and newly implemented drugs in patients with multidrug-resistant TBM resulted in low mortality and favorable neurologic outcomes.

Full Text

Duke Authors

Cited Authors

  • Smith, AGC; Gujabidze, M; Avaliani, T; Blumberg, HM; Collins, JM; Sabanadze, S; Bakuradze, T; Avaliani, Z; Kempker, RR; Kipiani, M

Published Date

  • August 2021

Published In

Volume / Issue

  • 25 / 8

Start / End Page

  • 632 - 639

PubMed ID

  • 34330348

Pubmed Central ID

  • PMC8443977

Electronic International Standard Serial Number (EISSN)

  • 1815-7920

International Standard Serial Number (ISSN)

  • 1027-3719

Digital Object Identifier (DOI)

  • 10.5588/ijtld.21.0159


  • eng