title: The role of aspirin in childhood tuberculous meningitis.
abstract: Arterial stroke is the main cause of poor outcome in childhood tuberculous meningitis. Aspirin has an antithrombotic action at low dose and anti-ischemic and anti-inflammatory properties, which are dose-related. The aim of the study was to explore the possible benefits of aspirin in children with tuberculous meningitis. A total of 146 consecutive children with a diagnosis of probable tuberculous meningitis were studied. Patients were randomized into 3 groups: (1) placebo group, (2) low-dose aspirin group, and (3) high-dose aspirin group. Twenty-nine additional patients who received aspirin before admission were excluded from the randomized study, but continued on low-dose aspirin. Aspirin, irrespective of dose, did not show any significant benefit regarding morbidity (hemiparesis and developmental outcome) and mortality. Aspirin was well tolerated, but 1 death was probably related to aspirin. The fact that the outcome of the high-dose aspirin group compared favorably with the other treatment groups despite younger age and more severe neurological involvement at baseline needs further investigation.
authors.affiliation: Department of Pediatrics and Child Health, Tygerberg Children's Hospital Faculty of Health Sciences, Stellenbosch University, South Africa. jfs@sun.ac.za
authors.forename: Johan F
authors.initials: JF
authors.lastname: Schoeman
authors.forename: Anita
authors.initials: A
authors.lastname: Janse van Rensburg
authors.forename: Jacoba A
authors.initials: JA
authors.lastname: Laubscher
authors.forename: Priscilla
authors.initials: P
authors.lastname: Springer
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010291:Paresis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D001241:Aspirin