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Duration of anti-tubercular treatment in tuberculous meningitis: Challenges and opportunity.
MedLine Citation:
PMID:  21045495     Owner:  NLM     Status:  In-Data-Review    
Background: The duration of anti-tuberculous therapy in tuberculous meningitis is controversial. There is variation in recommendations by different societies and expert groups on this issue. Objective: To determine the strength of evidence for short-term therapy in tuberculous meningitis through review of literature and critical appraisal. Materials and Methods: Cochrane CENTRAL (Issue 4, 2010), TRIP database, and PubMed (from 1966 to present) were searched for relevant papers with keywords 'meningeal tuberculosis' and tuberculous meningitis' combined with 'chemotherapy'. A critical appraisal of a systematic review was done using standard criteria. Results: A total of 10 relevant papers were identified. All papers were included in a systematic review. The systematic review did not specify study design of studies to be included, had only case series but no randomised controlled trial, and unclear definition of endpoints. Conclusions: The evidence base for short-term therapy for tuberculous meningitis is weak. There is a need to conduct a randomised controlled trial with non-inferiority hypothesis of adequate sample size with well-defined end points and adequate follow-up. This is a challenge as well as opportunity for Indian neurologists.
Kameshwar Prasad; Jitendra Kumar Sahu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology India     Volume:  58     ISSN:  0028-3886     ISO Abbreviation:  Neurol India     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-11-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0042005     Medline TA:  Neurol India     Country:  India    
Other Details:
Languages:  eng     Pagination:  723-6     Citation Subset:  IM    
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
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