The drug treatment of TBM continues to pose problems.
Unlike pulmonary tuberculosis, clear guidelines about the
choice of regimen and duration of treatment are lacking. By
analogy with pulmonary disease, patients generally receive
an intensive period of treatment then a continuation phase.
In TBM, four anti-tuberculous drugs are given initially:
isoniazid (with pyridoxine cover), rifampicin, pyrazinamide,
and one other, usually ethambutol or streptomycin. Of these,
isoniazid is likely to be the most important, given its ability to