Bibliographic information
Recommendation
In patients with tuberculous meningitis, an initial adjuvant corticosteroid therapy with dexamethasone or prednisolone tapered over 6-8 weeks should be used
Recommended in favor
Strong
Certainty of evidence
Moderate
Notes and Remarks
Subgroup considerations Steroids should be given regardless of the severity of meningitis. With regard to the use of steroids in tuberculous pericarditis, in one study an increase in HIV-related cancers (non-Hodgkins’ lymphoma and Kaposi sarcoma) was observed (52). However, this increase appears to be caused by co-administration of immunotherapy (M. indicus pranii). Implementation considerations Practitioners should give oral steroids if intravenous formulations are not available.
Also Featured In
This recommendation also appears in the following guidelines:
Guidelines for treatment of drug-susceptible tuberculosis and patient care
WHO consolidated guidelines on tuberculosis: module 4: treatment: drug-susceptible tuberculosis treatment.
WHO guidelines on the management of advanced HIV disease