Chemotherapy of tuberculous meningitis with isoniazid plus rifampicin - interim findings in a trial in children

Seventy six cases of tuberculous meningitis admitted to the Institute of Child Health and Hospital for Children, Madras were treated with a regimen of rifampicin, isoniazid and streptomycin daily for two months, followed by streptomycin twice a week plus ethambutol and isoniazid daily for 4 months. Treatment with isoniazid and ethambutol daily was continued for a further period of 6 months. In the earlier part of the study. isoniazid was prescribed in a dosage of 20 mg/kg. It was noted that about half of the children on isoniazid 20 mg/kg developed clinical jaundice with elevated levels of serum bilirubin and SGOT and SGPT levels. It was considered likely that the ‘high dosage of isoniazid might have contributed to the high incidence ofjaundice and hence the dosage of the same was reduced to 12 mg/kg. With the reduced dosage of isoniazid, the incidence of jaundice was much lower, namely 20 %. 54 patients have so far completed the treatment period of 1 year. 13 of these died after admission to the study. The clinical and laboratory findings are presented