Ethionamide versus ethambutol-containing first-line regimens for TB meningitis.

Ethionamide has emerged as an alternative to ethambutol for the treatment of tuberculous meningitis (TB meningitis). Here, we show that ethionamide- and ethambutol-containing first-line TB regimens achieved similar bactericidal activities in brain tissues and reduction in neuroinflammation in a mouse model of TB meningitis. However, ethionamide, but not ethambutol, achieves brain concentrations above the minimum inhibitory concentration for Mycobacterium tuberculosis.