Some opinions and problems on the treatment of tuberculous meningitis

doi:10.3969/j.issn.1000-6621.2019.04.002

Abstract

Abstract:

Tuberculous meningitis (TBM) is most serious type of TB with high mortality and disability rate. With the emergence of new epidemic characteristics of tuberculosis, such as high drug resistance rate and concurrent HIV infection, treatment of TBM faces serious challenges, and comprehensive treatment measures should be taken to improve the treatment effect of TBM. The author discussed the existing problems in the treatment of tuberculous meningitis, and the comprehensive treatment methods and their rational application combined with literature and clinical experience.

Key words: Tuberculosis, meningeal, Thinking, Comments, Comprehensive therapy

Yan MA,Wei-wei GAO. Some opinions and problems on the treatment of tuberculous meningitis[J]. Chinese Journal of Antituberculosis, 2019, 41(4): 371-376. doi: 10.3969/j.issn.1000-6621.2019.04.002

Figures/Tables 1

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抗结核药物	标准剂量	CSF/血浆药物浓度比值(%)	评价(药物透过血脑屏障能力)
INH	0.3g	80~90	良好
RFP	0.45(体质量<50g)或0.6g(体质量≥5kg)	10~20	较差
EMB	0.015g/kg	20~30	较差
PZA	1.5g(体质量<50kg)或2.0g(体质量≥50kg)	90~100	良好
Sm	0.015g/kg(最大剂量1g)	10~20	较差
Lfx	1g	70~80	较好
Mfx	0.4g	70~80	较好
Am	(0.015~0.02)g/kg	10~20	较差
Km	0.015g/kg	10~20	较差
Cm	(0.015~0.02)g/kg	-
PAS	10~12g	-	较差
Pto	(0.015~0.02)g/kg(最大剂量1g)	80~90	良好
Cs	(0.01~0.015)g/kg	80~90	良好
Lzd	1.2g	40~70	差异较大