Clinical Practice guidelines

بعض الطلاب او الزملاء اقترح لي انزل مقالات تكون في مجال واحد تخصصي ... لا ياحبيبي الان ماينفع لزم نقراء كل شي ونجمع معلومات عن كل شي وبعدين نبدا في مجال التخصص احنا الان في مرحلة بناء ولكم جزيل الشكر ❤️

Rifampicin is considered a crucial drug in patients with tuberculous meningitis, yet its poor CNS penetration and multiple drug interactions present challenges. ✅ Heemskerk and colleagues compared an intensified antituberculosis regimen containing higher dose rifampicin (15 mg/kg per day) and levofloxacin (20 mg/kg per day) for the first 8 weeks of treatment with a standard regimen (10 mg/kg per day rifampicin) in 817 Vietnamese adults with tuberculous meningitis. ❎ The group receiving intensified treatment did not have reduced mortality at 9 months

✅ Recommendations for the treatment of patients with drug susceptible tuberculous👈👉 meningitis generally include four drugs (ie, rifampicin, isoniazid, pyrazinamide, and ethambutol) at standard doses for: ✅ at least 2 months👉followed by rifampicin and isoniazid for a further 10 months. 🛜 In August, 2021, WHO issued a rapid communication suggesting that a 6month intensified regimen for patients with tuberculous meningitis could be used as an alternative to the standard 12 months in children and adolescents👉although supporting evidence for this statement from randomised controlled trials is scarce. ✅ Although 2010 WHO tuberculosis treatment guidelines👉recommended that streptomycin should replace ethambutol for treatment of patients with tuberculous meningitis, in practice the side effects of streptomycin and drug resistance have reduced its use.