Sir,
The recent on “tuberculous meningitis on directly observed thrice a week regime” is interesting.[1] Iype et al., noted that “RNTCP regimen was associated with good compliance, comparable mortality and morbidity.[1]” In fact, Iype et al., has ever reported a highly similar observation in Indian Journal of Tuberculosis and concluded that the new regime is not different from classical regime.[2] In fact, although the intermittent short course regime might seem convenient, the efficacy of this regime is still inconclusive. According to the meta-analysis, it is concluded that “Trials conducted to date are insufficient to support or refute the use of intermittent twice- or thrice-weekly, short-course treatment regimens over daily short-course treatment.[3]” In addition, the efficacy of the regime in cases with concomitant illness especially for HIV infection should be further systematically studied.
References
- 1.Iype T, Pillai AK, Cherian A, Nuju ZT, Pushpa C, Dae D, Krishnapillai V. Major outcomes of patients with tuberculous meningitis on directly observed thrice a week regime. Ann Indian Acad Neurol. 2014;17:281–6. doi: 10.4103/0972-2327.138496. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Iype T, George LE, Cherian A, Kumar A, Ajitha BK, Chandy S, et al. In-hospital mortality of intermittent vs daily antitubercular regimen in patients with meningeal tuberculosis--a retrospective study. Indian J Tuberc. 2012;59:6–11. [PubMed] [Google Scholar]
- 3.Bose A, Kalita S, Rose W, Tharyan P. Intermittent versus daily therapy for treating tuberculosis in children. Cochrane Database Syst Rev. 2014;1:CD007953. doi: 10.1002/14651858.CD007953.pub2. [DOI] [PMC free article] [PubMed] [Google Scholar]