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The IMAGINE-TBM trial, sponsored by the NIAID, aims to improve treatment for tuberculous meningitis (TBM) by comparing a six-month drug regimen with the standard nine-month regimen. TBM is fatal in 25–50% of adults and often results in permanent disabilities. The trial includes 330 participants aged 15 and older with TBM symptoms, including those with and without HIV, and some pregnant women. The study will evaluate high-dose rifampicin and linezolid’s efficacy, measuring participants’ clinical status over 48 weeks. Limited treatment options exist for pregnant women and adolescents with TBM, making this trial crucial. NIAID’s Therapeutics Research Programme Director, Peter Kim, is available for discussions. The study could revolutionise TBM treatment, potentially saving lives and reducing neurological disabilities.

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