Effectiveness and safety of the schedules of short and long term treatment for tuberculous meningoencephalitis at two hospitals of Lima--Peru

Neurologia. 2011 May;26(4):220-6. doi: 10.1016/j.nrl.2010.07.011. Epub 2010 Sep 28.
[Article in English, Spanish]

Abstract

Introduction: To compare the effectiveness and safety of short term 6 month-treatment and long term 12 month-treatment schedules for meningoencephalitis due to tuberculosis in two hospitals from Lima-Peru.

Methods: Comparative, retrospective and observational study. The patients were divided in two groups: Group 1: long term 12 month-treatment with isoniazid, rifampin, pyrazinamide, and ethambutol for the first 2 months; then isoniazid and rifampin for 10 months. Group 2: short term 6 month-treatment with isoniazid and rifampin, pyrazinamide and ethambutol for the first 2 months; then isoniazid and rifampin for 4 months. Clinical records, effectiveness, treatment failure, treatment side effects, mortality and late consequences after treatment were reviewed.

Results: Twenty-six patients with meningoencephalitis level I were included, 10 received the long term schedule and 16 the short term schedule treatment. From 51 patients with meningoencephalitis level II, 27 received the long term schedule and 24 the short term schedule treatment and of 31 patients with meningoencephalitis level III, 18 received the long term schedule treatment and 13 the short term schedule treatment. There was no statistically significant differences among levels I, II and III when effectiveness of short and long term schedule was evaluated. Moreover, there was no statistically significant difference in the frequency of treatment failure, treatment side effects, mortality and late consequences among groups.

Conclusions: Long term 12 month-treatment and short term 6 month-treatment had similar effectiveness and safety in the treatment of meningoenchephalitis due to tuberculosis in HIV negative patients.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / adverse effects
  • Antitubercular Agents / therapeutic use*
  • Drug Administration Schedule*
  • Drug Therapy, Combination
  • Ethambutol / administration & dosage
  • Ethambutol / adverse effects
  • Ethambutol / therapeutic use
  • Female
  • Hospitals*
  • Humans
  • Isoniazid / administration & dosage
  • Isoniazid / adverse effects
  • Isoniazid / therapeutic use
  • Male
  • Meningoencephalitis / drug therapy*
  • Meningoencephalitis / microbiology*
  • Meningoencephalitis / mortality
  • Meningoencephalitis / physiopathology
  • Middle Aged
  • Peru
  • Pyrazinamide / administration & dosage
  • Pyrazinamide / adverse effects
  • Pyrazinamide / therapeutic use
  • Retrospective Studies
  • Rifampin / administration & dosage
  • Rifampin / adverse effects
  • Rifampin / therapeutic use
  • Treatment Outcome
  • Tuberculosis, Meningeal / drug therapy*
  • Tuberculosis, Meningeal / mortality
  • Tuberculosis, Meningeal / physiopathology
  • Young Adult

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Ethambutol
  • Isoniazid
  • Rifampin