Abstract: Objective To explore the efficacy and safety of different doses of rifampicin in AIDS patients with tuberculous meningitis (TBM). Method The clinical data of 246 AIDS patients with tuberculous meningitis (AIDS/TBM) admitted to Chongqing Public Health Medical Treatment Center from January 2018 to December 2022 were retrospectively analyzed. The patients were divided into the 600mg R group and the 450mg R group according to the daily intravenous dose of rifampicin, and the differences in the treatment effect and adverse reactions of patients in different groups were compared and analyzed. Result Among the 246 patients included, 206 were in the 600mg rifampicin group (600mg R) and 40 were in the 450mg rifampicin group (450mg R) treated with rifampicin. There was no significant statistical difference in baseline conditions between the two groups of patients. When the two groups of patients were discharged after treatment, the incidence of consciousness disorders in patients of the 600mg R group (10.4%) was significantly lower than that in patients of the 450mg R group (21.5%), and the difference was statistically significant（P<0.05）. The total protein in cerebrospinal fluid of patients win the 600mg R group decreased more significantly than that of patients in the 450mg R group, and the difference was statistically significant（P<0.05）. The improvement rate (162/206, 78.7%) of patients in the 600mg R group was higher than that in the 450mg R group (24/40, 60%), while the non-improvement rate (39/206, 18.9%) and mortality rate (5/206, 2.4%) were lower than those in the 450mg R group (13/40, 32.5% and 3/40, 7.5%, respectively), with statistical significance (P<0.05). Conclusion The use of a higher dose of rifampicin (600mg/d) can improve the treatment effect of AIDS patients with tuberculous meningitis compared with 450mg/d rifampicin.

Key words: Acquired immune deficiency syndrome, Tuberculous meningitis, Rifampicin, Therapeutic dose