a Department of Neurology , King George Medical University , Lucknow , India.
Expert Rev Anti Infect Ther. 2018 Nov;16(11):813-831. doi: 10.1080/14787210.2018.1540930.
Drug-resistant tuberculous meningitis has been reported worldwide. Isoniazid mono-resistance is the most frequent cause of drug-resistant tuberculous meningitis, a life-threatening disease. Extensive drug-resistant tuberculous meningitis has also been reported in some isolated case reports. Areas covered: We reviewed the current literature on drug-resistant tuberculous meningitis, as well as drug-resistant tuberculosis. Expert commentary: Drug-resistant tuberculous meningitis is a life-threatening disease and needs prompt diagnosis and treatment. Xpert MTB/RIF Ultra technology can detect Mycobacterium tuberculosis and rifampicin resistance in cerebrospinal fluid (CSF) even with low numbers of bacilli. The optimum antituberculosis drug regimen for multidrug-resistant tuberculous meningitis is largely unknown as no second-line antituberculosis drug-containing regimen has been tested in a randomized controlled fashion in drug-resistant tuberculous meningitis. A combination of levofloxacin, kanamycin, ethionamide, linezolid, and pyrazinamide would be an appropriate regimen because of excellent CSF profile of most of these drugs. End TB Strategy will help in checking the increasing challenge of drug-resistant tuberculous meningitis as it aims to eliminate all kinds of tuberculosis by the year 2035.
耐药性结核性脑膜炎已在全球范围内报道。异烟肼单耐药是导致耐药性结核性脑膜炎的最常见原因，这是一种危及生命的疾病。在一些孤立的病例报告中也报道了广泛耐药性结核性脑膜炎。
我们回顾了关于耐药性结核性脑膜炎以及耐药性结核病的现有文献。
耐药性结核性脑膜炎是一种危及生命的疾病，需要及时诊断和治疗。Xpert MTB/RIF Ultra 技术即使在细菌数量较少的情况下，也能检测到脑脊液中的结核分枝杆菌和利福平耐药性。由于没有二线抗结核药物方案在耐药性结核性脑膜炎中以随机对照的方式进行过测试，因此对于耐多药结核性脑膜炎的最佳抗结核药物方案仍知之甚少。左氧氟沙星、卡那霉素、乙胺丁醇、利奈唑胺和吡嗪酰胺的联合用药方案是一种合适的方案，因为这些药物中的大多数在脑脊液中的表现都非常出色。终结结核战略将有助于应对耐药性结核性脑膜炎日益增加的挑战，因为该战略旨在到 2035 年消除所有类型的结核病。
