Most Severe Form of TB Calls for Intense Antibiotic Treatment
The medical journal Lancet Infectious Diseases has published the results of a study conducted by Radboud University Medical Centre researchers. The study shows that very high doses of antibiotics have a positive effect in fighting tuberculosis meningitis. This is an important discovery since this deadly disease has about a 50% mortality rate.
The only infectious disease that kills more people globally than TB is HIV. Last year, over 1.4 million people died from the disease and it is estimated that 8.7 million people were infected. It is the poorer countries of the world where the majority of infections and deaths occur from this disease. Most forms of it are highly treatable—and if the patient can afford it—regular testing is done is affluent lands.
TB meningitis is a form of TB that affects the protective fluid around the spinal cord and brain. Even for those who do not die from the disease, it can often result in catastrophic damage to the person’s nervous system. It’s a very rare form of TB (less than 5% of cases), but the disease mortality rate is so high that it is accountable for a significant amount of TB deaths.
The treatment for this form of TB is very similar to the treatment for other forms of the disease. However, since it is not as effective, researchers were looking for a new method to replace the 40 year old treatment technique. The reason that intense antibiotic doses were examined as a possible solution is that this is a common treatment for a number of neurological infections. Since certain TB treatments have trouble penetrating the brain, the use of other medicines has been sought.
The study was done by giving high doses of antibiotics to random patients amongst 60 at a hospital in Indonesia. By the end of 6 months about 65% of the patients who had received normal treatment for the disease had passed away versus only 35% of the patients who had received the more intense treatments. Also, the ones with the higher dosage showed more antibiotics in their blood and in their cerebrospinal fluid. The drugs used were rifampicin and moxifloxacin. The study was performed by Reinout van Crevel and Rob Aarnoutse.
Radboud UMC and other academic institutes in Indonesia have been continuing to collaborate to do research on both tuberculosis and HIV. For example, at Hasan Sadikin hospital and Padjadjaran, university researchers Ahmed Rizal Ganiem and Rovina Ruslami led collaborated research.
The research is not yet complete on TB meningitis. The next study will involve high doses of asprin along with the antibiotic treatments. This is hoped to reduce the risk of stroke, which is one common way that TB meningitis kills its victims. There is also research being done to determine why some who are infected with TB have it in their nervous system instead of their lungs.