40 Update on Tuberculosis for the General Paediatrician

Abstract

Exposure or Latent-TB-infection, or TB disease; because need different management. Although children, usually not been infectious, family prophylaxis interrupts disease's dissemination. 3. TB management: 1 TB exposure: H 2 months; repeat TST, if positive action as LTBI, 2 LTB infection: H 6-9 months or HR 3 months, 3 TB disease: Children living in high-HIV-prevalence or high-H-resistance area, with pulmonary/lymphadenitis TB; or children with extensive pulmonary disease in low-HIV-prevalence o low-H-resistance area, should be treated: 2 months HRZE + 4 months HR.-In meningitis TB: 2HRZE + 10 HR.-HIV-negative children and low-HIV-prevalence and low-H-resistance area, could be treated: 2HRZ + 4HR.-Maintenance period: thrice-weekly regimens can be considered, only if well established Directly Observed Therapy. HIV-infected children or living in HIV-high-prevalence area should not be treated with intermittent regimens.-Streptomycin should not be used as a part of firs-line regimen in pulmonary/lymphadenitis TB. Children with TB-MDR should be treated: fluoroquinolones + aminoglucoside guide by an expert.