Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Neurol India. 2010 Sep-Oct;58(5):723-6. doi: 10.4103/0028-3886.72182.
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.
To determine the strength of evidence for short-term therapy in tuberculous meningitis through review of literature and critical appraisal.
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.
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.
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.
结核性脑膜炎的抗结核治疗时间存在争议。不同的协会和专家组对此问题的建议存在差异。
通过文献复习和批判性评价，确定结核性脑膜炎短期治疗的证据强度。
检索 Cochrane CENTRAL（2010 年第 4 期）、TRIP 数据库和 PubMed（从 1966 年至今），使用“脑膜结核”和“结核性脑膜炎”的关键词组合与“化疗”，查找相关文献。使用标准标准对系统评价进行批判性评价。
共确定了 10 篇相关文献。所有文献均纳入系统评价。系统评价未具体说明纳入研究的设计，仅有病例系列但没有随机对照试验，终点定义也不明确。
结核性脑膜炎短期治疗的证据基础薄弱。需要进行一项具有足够样本量、明确终点和充分随访的非劣效性假设的随机对照试验。这对印度神经科医生来说既是挑战也是机遇。
