American Board of Internal Medicine (ABIM) Certification Practice Exam

What should the approach be for the duration of treatment for tuberculous meningitis in relation to the antibiotic sensitivity?

1. The fixed duration of 6 months

2. Determined by response to therapy and antibiotic sensitivities

3. A uniform duration of 12 months

4. Lasts no more than 4 months

The correct answer is: Determined by response to therapy and antibiotic sensitivities

The appropriate approach for the duration of treatment for tuberculous meningitis is to tailor it based on the patient's response to therapy and the antibiotic sensitivities of the Mycobacterium tuberculosis strain involved in the infection. Tuberculous meningitis is a severe form of tuberculosis that requires intensive treatment to ensure effective eradication of the bacteria and to prevent complications such as neurological damage. In practice, the treatment duration typically ranges from 9 to 12 months, depending on various factors, including the extent of the disease, the patient’s overall status, and the sensitivity of the drug used. If the strain is resistant to first-line agents, or if the patient’s condition does not improve as expected, extending the duration or modifying the treatment regimen may be necessary. This individualized approach ensures that patients receive adequate therapy based on their specific clinical situation, thus optimizing outcomes and minimizing the risk of recurrence or complications.