{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:39:34Z","timestamp":1790181574008,"version":"4.1.0"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wellcome Early Career","award":["300088Z\/23\/Z"],"award-info":[{"award-number":["300088Z\/23\/Z"]}]},{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"publisher","award":["R01-AI145435-A1"],"award-info":[{"award-number":["R01-AI145435-A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"publisher","award":["R01-AI190038"],"award-info":[{"award-number":["R01-AI190038"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"US National Institute of Health Fogarty International Center","award":["R21TW011035"],"award-info":[{"award-number":["R21TW011035"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculous meningitis (TBM) remains the deadliest form of tuberculosis. Inadequate penetration of rifampicin and ethambutol into the brain and cerebrospinal fluid (CSF) may contribute to mortality. Over the last decade, research has focused on \u201cintensified\u201d treatment (higher-dose first-line drugs or addition of second-line drugs with good CSF penetration). This systematic review and meta-analysis evaluates the impact of intensified TBM treatment on mortality, disability, and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted of clinical trials examining intensified TBM treatments compared with a rifampicin-based standard-of-care regimen in adults. Odds ratios (ORs) were calculated using a random-effects model with mortality as the primary outcome, with OR &amp;lt;1 indicating lower mortality. Disability and safety were examined as secondary outcomes. Subgroup analyses included (1) higher-dose rifampicin, (2) addition of fluoroquinolones, and (3) addition of linezolid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten trials meeting eligibility criteria, involving 1369 participants, were included. Higher-dose rifampicin (n = 1050; OR, 0.86; 95% CI, 0.54\u20131.35; P = .50), adjunctive fluoroquinolones (n = 1115; OR, 0.85; 95% CI, 0.56\u20131.27; P = .42), and linezolid (n = 79; OR, 0.73; 95% CI, 0.22\u20132.43; P = .61) did not significantly reduce TBM mortality. Due to heterogeneity in disability and safety endpoints, secondary outcomes could not be meta-analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current clinical trial evidence does not support the use of intensified TBM treatment in adults. However, these analyses are limited by diverse TBM case definitions, absence of MRC grading at enrollment, variable rifampicin dosing, limited data on linezolid and higher-dose isoniazid, and heterogeneous disability and safety outcomes. Use of uniform case definitions and consistent endpoints is essential to standardize data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf503","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T11:34:49Z","timestamp":1759750489000},"source":"Crossref","is-referenced-by-count":9,"title":["Intensified Treatment of Tuberculous Meningitis in Adults: A Systematic Review and Meta-analysis"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-2694","authenticated-orcid":false,"given":"Andrea","family":"Llamas-Lopez","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2296-2302","authenticated-orcid":false,"given":"James A","family":"Seddon","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London , London ,","place":["UK"]},{"name":"Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia C","family":"Chow","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Medicine (Infectious Diseases), University of California, San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7503-3320","authenticated-orcid":false,"given":"Caryn M","family":"Upton","sequence":"additional","affiliation":[{"name":"University of Cape Town Lung Institute, Cape Town ,","place":["Republic of South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-7070","authenticated-orcid":false,"given":"Sanjay K","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6703-0288","authenticated-orcid":false,"given":"Jan-Willem","family":"Alffenaar","sequence":"additional","affiliation":[{"name":"University of Sydney Institute for Infectious Diseases, University of Sydney , Sydney, NSW ,","place":["Australia"]},{"name":"Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney , Camperdown, NSW ,","place":["Australia"]},{"name":"Department of Pharmacy, Westmead Hospital , Westmead, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8001-6544","authenticated-orcid":false,"given":"Daniel J","family":"Grint","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Dooley","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Vanderbilt University Medical Center , Nashville, Tennessee ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Aarnoutse","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Radboudumc , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5070-532X","authenticated-orcid":false,"given":"Fiona V","family":"Cresswell","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine , London ,","place":["UK"]},{"name":"Global Health and Infection, Brighton and Sussex Medical School , Brighton ,","place":["UK"]},{"name":"Medical Research Council\/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"2025102314055526900_ofaf503-B1","volume-title":"Global Tuberculosis Report 2024","author":"World Health Organization","year":"2024","edition":"1st ed"},{"key":"2025102314055526900_ofaf503-B2","volume-title":"Global Tuberculosis Report 2023","author":"World Health Organization","year":"2023","edition":"1st ed"},{"key":"2025102314055526900_ofaf503-B3","doi-asserted-by":"crossref","first-page":"e0000069","DOI":"10.1371\/journal.pgph.0000069","article-title":"The global burden of tuberculous meningitis in adults: a modelling study","volume":"1","author":"Dodd","year":"2021","journal-title":"PLoS Glob Public Health"},{"key":"2025102314055526900_ofaf503-B4","first-page":"XXX\u2013XX","article-title":"Treatment outcomes in adult tuberculous meningitis: a systematic review and meta-analysis","volume":"7","author":"Stadelman","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"2025102314055526900_ofaf503-B5","doi-asserted-by":"crossref","first-page":"e0279203","DOI":"10.1371\/journal.pone.0279203","article-title":"Microbiological diagnosis and mortality of tuberculosis meningitis: systematic review and meta-analysis","volume":"18","author":"Seid","year":"2023","journal-title":"PLoS One"},{"key":"2025102314055526900_ofaf503-B6","volume-title":"Module 4: Treatment\u2014Drug-Susceptible Tuberculosis Treatment","author":"WHO Consolidated Guidelines on Tuberculosis","year":"2022","edition":"1st ed"},{"key":"2025102314055526900_ofaf503-B7","first-page":"CD012091","article-title":"Six months therapy for tuberculous meningitis","volume":"2017","author":"Jullien","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2025102314055526900_ofaf503-B8","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1128\/CMR.00007-10","article-title":"Penetration of drugs through the blood-cerebrospinal fluid\/blood-brain barrier for treatment of central nervous system infections","volume":"23","author":"Nau","year":"2010","journal-title":"Clin Microbiol Rev"},{"key":"2025102314055526900_ofaf503-B9","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/S0733-8619(05)70171-7","article-title":"The penetration of anti-infectives into the central nervous system","volume":"17","author":"Kearney","year":"1999","journal-title":"Neurol Clin"},{"key":"2025102314055526900_ofaf503-B10","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.tube.2010.07.002","article-title":"Cerebrospinal fluid concentrations of antituberculosis agents in adults and children","volume":"90","author":"Donald","year":"2010","journal-title":"Tuberculosis"},{"key":"2025102314055526900_ofaf503-B11","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1093\/cid\/ciab162","article-title":"High-dose oral and intravenous rifampicin for the treatment of tuberculous meningitis in predominantly human immunodeficiency virus (HIV)-positive Ugandan adults: a phase II open-label randomized controlled trial","volume":"73","author":"Cresswell","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025102314055526900_ofaf503-B12","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.3390\/pharmaceutics13091479","article-title":"Permeation challenges of drugs for treatment of neurological tuberculosis and HIV and the application of magneto-electric nanoparticle drug delivery systems","volume":"13","author":"Mhambi","year":"2021","journal-title":"Pharmaceutics"},{"key":"2025102314055526900_ofaf503-B13","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2025102314055526900_ofaf503-B14","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/0007-0971(81)90046-2","article-title":"A controlled trial of six months chemotherapy in pulmonary tuberculosis","volume":"75","author":"Somner","year":"1981","journal-title":"Br J Dis Chest"},{"key":"2025102314055526900_ofaf503-B15","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"Rob 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"2025102314055526900_ofaf503-B16","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S1473-3099(12)70264-5","article-title":"Intensified regimen containing rifampicin and moxifloxacin for tuberculous meningitis: an open-label, randomised controlled phase 2 trial","volume":"13","author":"Ruslami","year":"2013","journal-title":"Lancet Infect Dis"},{"key":"2025102314055526900_ofaf503-B17","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1056\/NEJMoa1507062","article-title":"Intensified antituberculosis therapy in adults with tuberculous meningitis","volume":"374","author":"Heemskerk","year":"2016","journal-title":"N Engl J Med"},{"key":"2025102314055526900_ofaf503-B18","doi-asserted-by":"crossref","first-page":"e01014-18","DOI":"10.1128\/AAC.01014-18","article-title":"Double-blind, randomized, placebo-controlled phase II dose-finding study to evaluate high-dose rifampin for tuberculous meningitis","volume":"62","author":"Dian","year":"2018","journal-title":"Antimicrob Agents Chemother"},{"key":"2025102314055526900_ofaf503-B19","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1093\/cid\/ciac932","article-title":"A phase 2A trial of the safety and tolerability of increased dose rifampicin and adjunctive linezolid, with or without aspirin, for human immunodeficiency virus-associated tuberculous meningitis: the LASER-TBM trial","volume":"76","author":"Davis","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2025102314055526900_ofaf503-B20","doi-asserted-by":"crossref","first-page":"2246","DOI":"10.1093\/jac\/dku103","article-title":"Safety and efficacy of levofloxacin versus rifampicin in tuberculous meningitis: an open-label randomized controlled trial","volume":"69","author":"Kalita","year":"2014","journal-title":"J Antimicrob Chemother"},{"key":"2025102314055526900_ofaf503-B21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.tube.2016.01.004","article-title":"Safety and efficacy of additional levofloxacin in tuberculous meningitis: a randomized controlled pilot study","volume":"98","author":"Kalita","year":"2016","journal-title":"Tuberculosis"},{"key":"2025102314055526900_ofaf503-B22","doi-asserted-by":"crossref","first-page":"3244","DOI":"10.1128\/AAC.00064-11","article-title":"Randomized pharmacokinetic and pharmacodynamic comparison of fluoroquinolones for tuberculous meningitis","volume":"55","author":"Thwaites","year":"2011","journal-title":"Antimicrob Agents Chemother"},{"key":"2025102314055526900_ofaf503-B23","doi-asserted-by":"crossref","first-page":"102351","DOI":"10.1016\/j.tube.2023.102351","article-title":"Escalate: linezolid as an add on treatment in the intensive phase of tubercular meningitis. A randomized controlled pilot trial","volume":"142","author":"Sahib","year":"2023","journal-title":"Tuberculosis"},{"key":"2025102314055526900_ofaf503-B24","doi-asserted-by":"crossref","first-page":"96","DOI":"10.4046\/trd.2019.0021","article-title":"Effectiveness of Intravenous isoniazid and ethambutol administration in patients with tuberculosis meningoencephalitis and HIV infection","volume":"83","author":"Butov","year":"2020","journal-title":"Tuberc Respir Dis"},{"key":"2025102314055526900_ofaf503-B25","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/S1473-3099(10)70138-9","article-title":"Tuberculous meningitis: a uniform case definition for use in clinical research","volume":"10","author":"Marais","year":"2010","journal-title":"Lancet Infect Dis"},{"key":"2025102314055526900_ofaf503-B26","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/0962-8479(94)90045-0","article-title":"Diagnostic criteria for tuberculous meningitis and their validation","volume":"75","author":"Ahuja","year":"1994","journal-title":"Tuber Lung Dis"},{"key":"2025102314055526900_ofaf503-B27","doi-asserted-by":"crossref","first-page":"e12033","DOI":"10.1002\/cesm.12033","article-title":"Multiarm studies and how to handle them in a meta-analysis: a tutorial","volume":"1","author":"Axon","year":"2023","journal-title":"Cochrane Evid Synth Methods"},{"key":"2025102314055526900_ofaf503-B28","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S1473-3099(16)30274-2","article-title":"High-dose rifampicin, moxifloxacin, and SQ109 for treating tuberculosis: a multi-arm, multi-stage randomised controlled trial","volume":"17","author":"Boeree","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2025102314055526900_ofaf503-B29","doi-asserted-by":"crossref","first-page":"3237","DOI":"10.1093\/jac\/dkab336","article-title":"Pharmacokinetics and safety of high-dose rifampicin in children with TB: the Opti-Rif trial","volume":"76","author":"Garcia-Prats","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"2025102314055526900_ofaf503-B30","doi-asserted-by":"crossref","first-page":"eaau0965","DOI":"10.1126\/scitranslmed.aau0965","article-title":"Noninvasive11 C-rifampin positron emission tomography reveals drug biodistribution in tuberculous meningitis","volume":"10","author":"Tucker","year":"2018","journal-title":"Sci Transl Med"},{"key":"2025102314055526900_ofaf503-B31","doi-asserted-by":"crossref","first-page":"e155851","DOI":"10.1172\/JCI155851","article-title":"High-dose rifampin improves bactericidal activity without increased intracerebral inflammation in animal models of tuberculous meningitis","volume":"132","author":"Ruiz-Bedoya","year":"2022","journal-title":"J Clin Invest"},{"key":"2025102314055526900_ofaf503-B32","doi-asserted-by":"crossref","first-page":"2000955","DOI":"10.1183\/13993003.00955-2020","article-title":"Increased bactericidal activity but dose-limiting intolerability at 50\u2005mg\u00b7kg\u22121 rifampicin","volume":"58","author":"Te Brake","year":"2021","journal-title":"Eur Respir J"},{"key":"2025102314055526900_ofaf503-B33","doi-asserted-by":"crossref","first-page":"e0014021","DOI":"10.1128\/AAC.00140-21","article-title":"Plasma pharmacokinetics of high-dose oral versus intravenous rifampicin in patients with tuberculous meningitis: a randomized controlled trial","volume":"65","author":"Wasserman","year":"2021","journal-title":"Antimicrob Agents Chemother"},{"key":"2025102314055526900_ofaf503-B34","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ijid.2019.04.026","article-title":"Attainment of target rifampicin concentrations in cerebrospinal fluid during treatment of tuberculous meningitis","volume":"84","author":"Mezochow","year":"2019","journal-title":"Int J Infect Dis"},{"key":"2025102314055526900_ofaf503-B35","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/jcpt.13555","article-title":"High-dose rifampicin for the treatment of tuberculous meningitis: a meta-analysis of randomized controlled trials","volume":"47","author":"Cao","year":"2022","journal-title":"J Clin Pharm Ther"},{"key":"2025102314055526900_ofaf503-B36","doi-asserted-by":"crossref","first-page":"312","DOI":"10.4103\/ijmy.ijmy_135_21","article-title":"Safety and efficacy of high-dose rifampicin in the management of tuberculosis meningitis: systematic review and meta-analysis","volume":"10","author":"Charlie","year":"2021","journal-title":"Int J Mycobacteriol"},{"key":"2025102314055526900_ofaf503-B37","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1093\/cid\/cix230","article-title":"Clinical outcomes of patients with drug-resistant tuberculous meningitis treated with an intensified antituberculosis regimen","volume":"65","author":"Heemskerk","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2025102314055526900_ofaf503-B38","volume-title":"Module 4: Treatment\u2014Drug-Resistant Tuberculosis Treatment, 2022 Update","author":"WHO Consolidated Guidelines on Tuberculosis","year":"2022","edition":"1st ed"},{"key":"2025102314055526900_ofaf503-B39","doi-asserted-by":"crossref","first-page":"107048","DOI":"10.1016\/j.ijantimicag.2023.107048","article-title":"Linezolid does not improve bactericidal activity of rifampin-containing first-line regimens in animal models of TB meningitis","volume":"63","author":"Tucker","year":"2024","journal-title":"Int J Antimicrob Agents"},{"key":"2025102314055526900_ofaf503-B40","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1164\/rccm.200904-0611OC","article-title":"Addition of PNU-100480 to first-line drugs shortens the time needed to cure murine tuberculosis","volume":"180","author":"Williams","year":"2009","journal-title":"Am J Respir Crit Care Med"},{"key":"2025102314055526900_ofaf503-B41","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S1473-3099(18)30480-8","article-title":"Substitution of ethambutol with linezolid during the intensive phase of treatment of pulmonary tuberculosis: a prospective, multicentre, randomised, open-label, phase 2 trial","volume":"19","author":"Lee","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2025102314055526900_ofaf503-B42","doi-asserted-by":"crossref","first-page":"XXX\u2013XX","DOI":"10.1093\/ofid\/ofab345","article-title":"Tuberculous meningitis: impact of timing of treatment initiation on mortality","volume":"8","author":"Soria","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"2025102314055526900_ofaf503-B43","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1080\/00365540902849391","article-title":"Acute bacterial meningitis in adults: predictors of outcome","volume":"41","author":"Dzupova","year":"2009","journal-title":"Scand J Infect Dis"},{"key":"2025102314055526900_ofaf503-B44","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.eplepsyres.2018.10.005","article-title":"Seizures in tuberculous meningitis","volume":"148","author":"Misra","year":"2018","journal-title":"Epilepsy Res"},{"key":"2025102314055526900_ofaf503-B45","doi-asserted-by":"crossref","first-page":"896","DOI":"10.4103\/0028-3886.190258","article-title":"Hydrocephalus and vasculitis delay therapeutic responses in tuberculous meninigitis: results of Haydarpasa-III study","volume":"64","author":"Cag","year":"2016","journal-title":"Neurol India"},{"key":"2025102314055526900_ofaf503-B46","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.2217\/fmb.12.86","article-title":"Tuberculous meningitis in adults: a review of a decade of developments focusing on prognostic factors for outcome","volume":"7","author":"Brancusi","year":"2012","journal-title":"Future Microbiol"},{"key":"2025102314055526900_ofaf503-B47","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/S1474-4422(19)30154-1","article-title":"The neurocritical care of tuberculous meningitis","volume":"18","author":"Donovan","year":"2019","journal-title":"Lancet Neurol"},{"key":"2025102314055526900_ofaf503-B48","doi-asserted-by":"crossref","first-page":"177","DOI":"10.12688\/wellcomeopenres.15515.1","article-title":"Establishing the cascade of care for patients with tuberculous meningitis","volume":"4","author":"Imran","year":"2019","journal-title":"Wellcome Open Res"},{"key":"2025102314055526900_ofaf503-B49","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1056\/NEJMoa040573","article-title":"Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults","volume":"351","author":"Thwaites","year":"2004","journal-title":"N Engl J Med"},{"key":"2025102314055526900_ofaf503-B50","first-page":"CD002244","article-title":"Corticosteroids for managing tuberculous meningitis","volume":"4","author":"Prasad","year":"2016","journal-title":"Cochr Database Syst Rev"},{"key":"2025102314055526900_ofaf503-B51","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1056\/NEJMoa2216218","article-title":"Adjunctive dexamethasone for tuberculous meningitis in HIV-positive adults","volume":"389","author":"Donovan","year":"2023","journal-title":"N Engl J Med"},{"key":"2025102314055526900_ofaf503-B52","doi-asserted-by":"crossref","first-page":"100819","DOI":"10.1016\/j.eclinm.2021.100819","article-title":"Efficacy and safety of aspirin as an adjunctive therapy in tubercular meningitis: a systematic review and meta-analysis","volume":"34","author":"Rohilla","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2025102314055526900_ofaf503-B53","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.3390\/pathogens11111291","article-title":"Host-directed therapies for tuberculosis","volume":"11","author":"Jeong","year":"2022","journal-title":"Pathogens"},{"key":"2025102314055526900_ofaf503-B54","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S1474-4422(21)00435-X","article-title":"Tuberculous meningitis: progress and remaining questions","volume":"21","author":"Huynh","year":"2022","journal-title":"Lancet Neurol"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/10\/ofaf503\/64536532\/ofaf503.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/10\/ofaf503\/64536532\/ofaf503.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T18:06:11Z","timestamp":1761242771000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofaf503\/8276755"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,29]]},"references-count":54,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,9,29]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofaf503","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,9,29]]},"article-number":"ofaf503"}}