Isoniazid Resistance and Tuberculous Meningitis

Among patients with tuberculous meningitis and positive cerebrospinal fluid cultures, initial isoniazid resistance significantly raised the risk for death.

Tuberculous meningitis, a devastating manifestation of tuberculosis (TB), has become more common since the convergence of the TB and HIV epidemics. Isoniazid (INH) is the only bactericidal component of modern antituberculous therapy that easily crosses the blood–brain barrier, and it is the first-line drug with the strongest early bactericidal activity. When INH has been used in combination with other active antituberculous drugs, initial INH resistance has not been associated with poorer outcomes in patients with pulmonary TB. But what about patients with tuberculous meningitis?

Using records from the CDC's National Tuberculosis Surveillance System, researchers examined data on cases of tuberculous meningitis reported from 1993 (when drug-s…

Reviewing Author

Stephen G. Baum, MD

Disclosures

Consultant/Advisory BoardClinical Infectious Diseases

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Editorial BoardsMedical Letter

Stephen G. Baum, MD

Disclosures

Consultant/Advisory BoardClinical Infectious Diseases

RoyaltiesUpToDate

Editorial BoardsMedical Letter