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rdf:type |
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lifeskim:mentions |
umls-concept:C0001675,
umls-concept:C0030705,
umls-concept:C0035608,
umls-concept:C0041318,
umls-concept:C0087111,
umls-concept:C0282386,
umls-concept:C0282440,
umls-concept:C0442711,
umls-concept:C0444956,
umls-concept:C1096777,
umls-concept:C1442989,
umls-concept:C1707455
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pubmed:dateCreated |
2011-2-21
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pubmed:databankReference |
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pubmed:abstractText |
Tuberculous meningitis is the most severe form of tuberculosis. Mortality for untreated tuberculous meningitis is 100%. Despite the introduction of antibiotic treatment for tuberculosis the mortality rate for tuberculous meningitis remains high; approximately 25% for HIV-negative and 67% for HIV positive patients with most deaths occurring within one month of starting therapy. The high mortality rate in tuberculous meningitis reflects the severity of the condition but also the poor antibacterial activity of current treatment regimes and relatively poor penetration of these drugs into the central nervous system. Improving the antitubercular activity in the central nervous system of current therapy may help improve outcomes. Increasing the dose of rifampicin, a key drug with known poor cerebrospinal fluid penetration may lead to higher drug levels at the site of infection and may improve survival. Of the second generation fluoroquinolones, levofloxacin may have the optimal pharmacological features including cerebrospinal fluid penetration, with a ratio of Area Under the Curve (AUC) in cerebrospinal fluid to AUC in plasma of >75% and strong bactericidal activity against Mycobacterium tuberculosis. We propose a randomized controlled trial to assess the efficacy of an intensified anti-tubercular treatment regimen in tuberculous meningitis patients, comparing current standard tuberculous meningitis treatment regimens with standard treatment intensified with high-dose rifampicin and additional levofloxacin.
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pubmed:grant |
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pubmed:commentsCorrections |
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-10448488,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-11282270,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-11897584,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-12458143,
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http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-18350135,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-18906655,
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http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-7028436,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-8144431,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-9265429,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-9310011,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-9420037,
http://linkedlifedata.com/resource/pubmed/commentcorrection/21288325-9597244
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
IM
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pubmed:chemical |
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pubmed:status |
MEDLINE
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pubmed:issn |
1745-6215
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pubmed:author |
pubmed-author:BangNguyen DucND,
pubmed-author:CawsMaxineM,
pubmed-author:ChauTran Thi HongTT,
pubmed-author:DayJeremyJ,
pubmed-author:DungNguyen HuyNH,
pubmed-author:FarrarJeremyJ,
pubmed-author:HeemskerkDorotheeD,
pubmed-author:MersonLauraL,
pubmed-author:OlliaroPieroP,
pubmed-author:PouplinThomasT,
pubmed-author:WolbersMarcelM,
pubmed-author:YenNguyen Thi BichNT
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pubmed:issnType |
Electronic
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pubmed:volume |
12
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
25
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pubmed:dateRevised |
2011-7-25
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pubmed:meshHeading |
pubmed-meshheading:21288325-Adult,
pubmed-meshheading:21288325-Antitubercular Agents,
pubmed-meshheading:21288325-Disability Evaluation,
pubmed-meshheading:21288325-Double-Blind Method,
pubmed-meshheading:21288325-Drug Therapy, Combination,
pubmed-meshheading:21288325-HIV Infections,
pubmed-meshheading:21288325-Humans,
pubmed-meshheading:21288325-Neurologic Examination,
pubmed-meshheading:21288325-Ofloxacin,
pubmed-meshheading:21288325-Research Design,
pubmed-meshheading:21288325-Rifampin,
pubmed-meshheading:21288325-Sample Size,
pubmed-meshheading:21288325-Time Factors,
pubmed-meshheading:21288325-Treatment Outcome,
pubmed-meshheading:21288325-Tuberculosis, Meningeal,
pubmed-meshheading:21288325-Vietnam
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pubmed:year |
2011
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