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CNS Drugs
Published in: CNS Drugs 11/2023

17-11-2023 | Neurotuberculosis | Review Article

Current Insights into Diagnosing and Treating Neurotuberculosis in Adults

Authors: Sofiati Dian, Ahmad Rizal Ganiem, Lindsey HM te Brake, Arjan van Laarhoven

Published in: CNS Drugs | Issue 11/2023

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Abstract

Neurotuberculosis has the highest morbidity and mortality risk of all forms of extrapulmonary tuberculosis (TB). Early treatment is paramount, but establishing diagnosis are challenging in all three forms of neurotuberculosis: tuberculous meningitis (TBM), spinal TB and tuberculomas. Despite advancements in diagnostic tools and ongoing research aimed at improving TB treatment regimens, the mortality rate for neurotuberculosis remains high. While antituberculosis drugs were discovered in the 1940s, TB treatment regimens were designed for and studied in pulmonary TB and remained largely unchanged for decades. However, new antibiotic regimens and host-directed therapies are now being studied to combat drug resistance and contribute to ending the TB epidemic. Clinical trials are necessary to assess the effectiveness and safety of these treatments, addressing paradoxical responses in neurotuberculosis cases and ultimately improving patient outcomes. Pharmacokinetic–pharmacodynamic analyses can inform evidence-based dose selection and exposure optimization. This review provides an update on the diagnosis and treatment of neurotuberculosis, encompassing both sensitive and resistant antituberculosis drug approaches, drawing on evidence from the literature published over the past decade.
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Metadata
Title
Current Insights into Diagnosing and Treating Neurotuberculosis in Adults
Authors
Sofiati Dian
Ahmad Rizal Ganiem
Lindsey HM te Brake
Arjan van Laarhoven
Publication date
17-11-2023
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 11/2023
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.1007/s40263-023-01047-y

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