Efficacy and safety of parenteral anti-tuberculosis therapy of patients with TB meningitis compared to standard treatment

Abstract

Background: The objective of this work was to study the efficacy and safety of parenteral anti-TB therapy in treatment of patients with TB meningitis in comparison with standard antimycobacterial therapy. Methods: The study involved 44 patients with TB me¬ningitis. Patients were allocated to two groups. The first (control) group (n=31) received standard anti-TB the¬rapy (isoniazid 0.3 g), rifampicin (0.6 g), pyrazinamide (2 g) and ethambutol (1.2 g) - per os. The 2nd (main) group (n=13) received parenteral anti-TB therapy (iso¬niazid 0.5 g) - i/m, rifampicin (0.6 g) - i/v, ethambutol (1.0 g) - i/v and pyrazinamide (2 g) - per os. Results: After a week of chemotherapy 5 (16.1±6.6%) patients from 1st group and 10 (79.9±12.1%) patients from 2nd group had a positive dynamics: a decrease in the severity of cerebral symptoms, a decrease in focal neurological symptoms, liquorological and liquorody¬namic changes (19.3±3.8%), pleocytosis (22.9±7.2%) and cerebrospinal pressure to (210±30) mm.v.st.) and intoxication syndrome (p< 0.05). After two weeks of anti-tuberculosis the¬rapy, improvement of these parameters was observed in 10 (32.2±8.4%) patients of the 1st group and 11 (84.6±10.4%) - 2nd groups (p< 0.05). The mortality rate was significantly lower in the 2nd group (1 patient (7.6±7.6%)) compared to 8 patients of the 1st group (25.8±7.8%),p < 0.05. In addition, parenteral anti-TB therapy provided reduction of side effects by 23%. Conclusions: Administration of parenteral anti-TB the¬rapy in patients with TB meningitis resulted in a com¬paratively quick reduction of disease manifestation and reduce mortality.