What medications are used to treat tuberculous meningitis?

Generally, tuberculous meningitis is a severe infectious disease caused by Mycobacterium tuberculosis invading the meninges. Common symptoms include low-grade fever with night sweats, severe headache, projectile vomiting, nuchal rigidity, and mental depression. Patients should follow medical advice to undergo standardized treatment with oral medications such as isoniazid tablets, rifampicin capsules, pyrazinamide tablets, ethambutol hydrochloride tablets, and isoniazid with para-aminosalicylic acid tablets. Detailed explanations are as follows:

1. Isoniazid Tablets

As a core first-line anti-tuberculosis drug, isoniazid specifically inhibits the synthesis of the cell wall of Mycobacterium tuberculosis and exerts potent bactericidal effects on actively growing bacteria. This drug can effectively cross the blood-brain barrier and maintain effective therapeutic concentrations in cerebrospinal fluid, making it a key oral medication for controlling meningitis tuberculosis infection.

2. Rifampicin Capsules

Rifampicin achieves bactericidal effects by inhibiting bacterial nucleic acid synthesis through blocking the activity of RNA polymerase in Mycobacterium tuberculosis. It is effective against both growing and dormant bacteria. When used in combination with isoniazid, it enhances anti-tuberculosis efficacy and can cross the blood-brain barrier, meeting the oral treatment requirements for tuberculous meningitis.

3. Pyrazinamide Tablets

This drug exhibits significant bactericidal activity against Mycobacterium tuberculosis in acidic environments and is particularly effective at eliminating intracellular parasites. It can cross the blood-brain barrier into the cerebrospinal fluid and, when used in combination with other oral anti-tuberculosis drugs, shortens treatment duration and reduces the probability of disease recurrence, making it an important oral medication in combination therapy regimens.

4. Ethambutol Hydrochloride Tablets

It exerts bacteriostatic effects by interfering with the synthesis of the Mycobacterium tuberculosis cell wall. Although its ability to cross the blood-brain barrier is relatively weak, it can delay the development of bacterial resistance when used in combination with other oral drugs. It is suitable for inclusion in oral combination therapy regimens for tuberculous meningitis. Regular vision checks are necessary during treatment to prevent optic nerve damage.

5. Isoniazid with Para-Aminosalicylic Acid Tablets

This is a compound preparation of isoniazid and para-aminosalicylic acid. The former kills bacteria, while the latter delays the development of isoniazid resistance. After oral administration, this drug can stably release active ingredients in the body, assist in controlling meningeal infection after crossing the blood-brain barrier, and is suitable for patients requiring long-term oral treatment.

Maintain regular作息 habits in daily life and avoid excessive fatigue. In terms of diet, reduce intake of spicy and greasy foods such as chili peppers and fried foods, and consume more eggs, milk, fresh fruits, and vegetables to supplement nutrition. Patients with underlying conditions such as hyperthyroidism or hypothyroidism should synchronously monitor their baseline disease indicators during treatment and promptly adjust medication plans.