Drug-resistant Tuberculosis

Abstract

Drug-resistant Mycobacterium tuberculosis (TB) infection represents a serious and growing problem. For patients infected or suspected of being infected with multidrug or extensively drug-resistant TB, several medications have to be given simultaneously for prolonged periods. Here, we review the literature on treatment and monitoring of adverse effects of pediatric drug-resistant TB therapy in a high resource, low TB burden setting.

Treatment outcomes for children with multidrug-resistant tuberculosis: a systematic review and meta-analysis

“…We were unable to compare the prevalence of adverse events for children and adults because summary estimates were not available for adults. 15,29 In line with expert opinion 30 and reviews, 31 our subgroup analysis suggested that the use of injectable drugs was associated with improved treatment outcomes for paediatric MDR tuberculosis. The best possible duration of treat ment for MDR tuberculosis is not established, and recom mendations are largely based on expert opinion.…”

Isoniazid- and Streptomycin-Resistant Miliary Tuberculosis Complicated by Intracranial Tuberculoma in a Japanese Infant

“…TH can pass the blood-brain barrier very well (Donald 2010). On the other hand, TH is one of the second-line drugs against drug-resistant TB Al-Dabbagh et al 2011) and can cause liver toxicity. As TH has a chemical structure similar to that of INH, TH resistance should be suspected when INH resistant is present.…”

“…Insufficient evidence has been accumulated regarding the treatment of drug-resistant TB in children, so the most effective treatment regimens remain unclear. Several guidelines for drug-resistant TB in children have been published recently Al-Dabbagh et al 2011). According to these guidelines, with extensive pulmonary or disseminated extra-pulmonary disease, a minimum of 4 active drugs should be included in the treatment regimen.…”

Childhood Tuberculosis

“…MDR-TB strains are resistant to INH and RMP, whereas XDR-TB is also resistant to fluoroquinolones and at least one of the secondline injectable drugs (amikacin, kanamycin, and capreomycin) [84]. XDR strains were first reported in 2006 [62].…”