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The progress of tuberculous meningitis medical management in adults

Imron A, Hermanto Y, Yudha TW, Rizal A, Dewi VYK, Ruslami R

Surgical neurology international, 2026

Abstract

Background: Tuberculous meningitis (TBM) is the most common central nervous system (CNS) infection caused by "Mycobacterium tuberculosis," leading to significant neurological deficits and high mortality rates. Effective treatment is essential to control the infection. This literature review aims to evaluate recent advancements in anti-tuberculosis therapy for TBM, focusing on optimizing treatment regimens.

Methods: This literature review primarily draws from studies available in the PubMed and Scopus databases on TBM regimens, focusing on publications that evaluate higher doses or novel drug therapies. Key search terms included "tuberculous meningitis," "anti-tuberculosis therapy," and "novel treatment regimens."

Results: Findings suggest that while standard tuberculosis (TB) regimens are effective for pulmonary TB, they may be suboptimal for TBM due to limited CNS drug penetration. Recent investigations propose higher drug doses and novel medications to enhance efficacy in TBM treatment.

Conclusion: The review highlights the need for TBM-specific treatment regimens with optimized dosing and new drug formulations to improve patient outcomes. Further research is needed to validate these emerging therapies.

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