5.2. Treatment regimens for TB meningitis in children and adolescents


In children and adolescents with bacteriologically confirmed or clinically diagnosed TB meningitis (without suspicion or evidence of MDR/RR-TB), a 6-month intensive regimen (6HRZEto) may be used as an alternative option to the 12-month regimen (2HRZE/10HR) (Conditional recommendation, very low certainty of the evidence).


  • The shorter intensive regimen is suitable for children and adolescents who have no evidence of drug resistance and in children and adolescents who have a low likelihood of drug-resistant TB, e.g. those without risk factors for any form of drug-resistant TB.
  • The recommendation from the Guidance for national tuberculosis programmes on the management of tuberculosis in children (second edition, 2014) remains an option for the treatment of children and adolescents with suspected or confirmed TB meningitis (TBM): Children and adolescents with suspected or confirmed tuberculous meningitis should be treated with a four-drug regimen (HRZE) for 2 months, followed by a two-drug regimen (HR) for 10 months, the total duration of treatment being 12 months (Strong recommendation, low certainty of evidence).
  • Due to a lack of data, the shorter intensive treatment regimen recommendation should not be used in children and adolescents living with HIV who are diagnosed with TB meningitis.

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