The study examined high-dose oral rifampicin in adult patients with tuberculous meningitis compared with standard treatment. The main objective was to improve survival by giving 35 mg/kg rifampicin for 8 weeks instead of the standard 10 mg/kg. The study was published in the New England Journal of Medicine (Volume 393, Issue 24, Pages 2434-2446). Meta-analyses show that high-dose rifampicin (above 30 mg/kg/day) did not improve mortality (OR 0.86; 95% CI 0.54–1.35 in 1050 patients), but increased the incidence of serious adverse events compared with the standard dose of 10–14 mg/kg/day. Previous trials with slightly higher doses (15 mg/kg/day) of levofloxacin did not show significant changes in outcomes. Larger ongoing studies such as INTENSE-TBM, HARVEST and IMAGINE-TBM will provide further data on the safety of high doses. Standard treatment included rifampicin quadruple therapy lasting at least 6 months.