Evidence map›Paper›PMID 29492737›Full record

ReviewCurrent treatment options in neurology2018

Treatment of Tuberculous Meningitis and Its Complications in Adults.

Angharad Davis, Graeme Meintjes, Robert J Wilkinson

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Current treatment options in neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 pooled it
11.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 94 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Review
  11. Impact of new regimens and drugs on rifampin-resistant tuberculosis management in Mexico.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025
    Article
  12. Tuberculous meningitis leading to stroke: a case report.Annals of medicine and surgery (2012) · 2024
    Article
  13. Review
  14. Review
  15. Review
  16. The Neuro-Ophthalmology of Tuberculosis.Neuro-ophthalmology (Aeolus Press) · 2024
    Review
  17. Review
  18. Article
  19. Article
  20. The Challenges of Diagnosing Tuberculous Meningitis and Importance of Early Intervention.Journal of community hospital internal medicine perspectives · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 2 countries.

Angharad DavisNational Hospital for Neurology and Neurosurgery, University College London Hospitals, London, WC1N 3BG, UK. angharadgracedavis@gmail.com.
Graeme MeintjesWellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, Observatory, Cape Town, 7925, Republic of South Africa.
Robert J WilkinsonUniversity College London, Gower Street, London, WC1E 6BT, UK.
Wellcome Centre for Infectious Diseases Research in Africa · ZAUniversity College London · GB

Funding

Medical Research Council MC_U117588499
6 · The paper itself

Abstract

purpose of reviewTuberculous meningitis (TBM) is a global health problem. In this review, we systematically evaluate the evidence for current and emerging antimicrobials, host-directed therapies and supportive managements. RECENT

findingsCurrent antimicrobial regimes do not factor the differing ability of drugs to cross the blood-brain barrier. Rifampicin may be more effective at higher doses yet the most recent clinical trial failed to demonstrate survival benefit at 15 mg/kg/day. Dose finding studies suggest that higher doses still may be safe and more effective. Fluoroquinolones are currently listed as important second-line agents in drug-resistant TBM; however, a survival benefit as a first-line agent has yet to be shown. Linezolid may be a promising antimicrobial with good central nervous system penetrance. Dexamethasone reduces mortality in HIV-uninfected individuals yet evidence for its use in HIV co-infection is lacking. Aspirin has anti-inflammatory and anti-thrombotic properties. Small studies have demonstrated efficacy in reducing stroke but further research is required to better understand its effect on controlling the host inflammatory response. Discovery of genetic polymorphisms may direct individualized immune therapies and mediators of the innate immune response may provide targets for the development of novel therapies. There is at present no significant evidence base to guide management of hydrocephalus in HIV co-infection. Further clinical trial data is required to improve treatment outcomes in TBM in particularly in regard to the value of high-dose rifampicin, newer antimicrobials with improved central nervous system penetration and host-directed therapies. Supportive measures in particular the management of hydrocephalus in HIV co-infection should be an area for future research.

Indexed as

Anti-tuberculous therapiesHuman immunodeficiency virusHydrocephalusImmunotherapiesTuberculomaTuberculous meningitis

Identifiers

PMID29492737
PMCPMC5830467
OpenAlexW2792305369

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.