What do you do when there are little data to guide your decision-making? Tune in to hear Drs Felicia C. Chow, Regan R. Solomons, and Kelly E. Dooley discuss managing complicated cases of TBM.
care. In the United States, TBM is a very rare condition. I think that people tend to treat patients with TBM somewhat on a case-by-case basis in terms of right drugs and selection of doses. The general guidance is to treat TBM in much the same way we treat pulmonary TB, that is, with an intensive phase of four drugs. So
rifampin, isoniazid, pyrazinamide, and ethambutol, followed by a continuation phase of rifampin and isoniazid . That continuation phase is prolonged to 9-12 months. In contradistinction to how Regan is describing the drugs that they use in South Africa for children with TBM, [a method that takes] into account drug distribution into the brain and cerebrospinal fluid in somewhat higher doses and different drug selection to try to get drugs to the site of disease at sufficient concentrations, what to do with adults is a little bit less clear.
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