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The Treatment of Tuberculous Meningitis Without Injections

W. P. SWEETNAM, M.D., M.R.C.P., D.P.H., D.C.H.; C. G. W. SYKES, M.B., D.R.C.O.G., D.C.H.
AMA Am J Dis Child. 1956;92(1):2-4. doi:10.1001/archpedi.1956.02060030004002.
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The treatment of tuberculous meningitis has undergone a progressive review following the introduction of streptomycin and later of aminosalicylic acid (PAS) and isoniazid. Streptomycin has two main disadvantages—the need for prolonged injections and the occasional toxicity of the antibiotic. Oral isoniazid has been shown to produce adequate bacteriostatic levels in the C. S. F. (Fletcher, 1953) and to be virtually nontoxic (Medical Research Council, 1953).

Smellie (1954) has drawn attention to the pain and suffering caused to children by prolonged courses of intrathecal and intramuscular injections, and suggests, from his own experience, that intrathecal treatment can be dispensed with. Morin (1952) obtained promising results in five patients with the use of isoniazid alone, a short course of intrathecal treatment being given. Applebaum and Anderson (1954) report 7 recoveries in 10 cases treated with isoniazid or iproniazid; in 3 cases the initial therapy was administered intramuscularly. Sweetnam and Murphy (1952, 1954)


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