Multidrug-Resistant Tuberculosis in Child Successfully Treated with 9-Month Drug Regimen

Achar, Jay; Berry, Catherine; Herboczek, Krzysztof; Parpieva, Nargiza; Tillyashaykhov, Mirzagaleb; Tigay, Zinaida; Khamraev, Atadjan; Velivela, Kalyan; Seddon, James A; Cros, Philipp du

doi:10.3201/eid2111.151119

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…57 Among 27 adolescents receiving bedaquiline-containing regimens, five experienced clinically significant QT prolongation; these events were managed without withdrawal of bedaquiline. 58 Skin discolouration is a common adverse effect of clofazimine. 59 Skin hyperpigmentation has been associated with poorer perceived quality of life in younger adults (aged <35 years), 60 so this effect is likely to be distressing and stigmatising for adolescents and may lead to decreased adherence and treatment discontinuation.…”

Section: Rifampicin Resistant Tuberculosismentioning

confidence: 99%

Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

116

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Adolescence is characterised by a dramatic increase in the incidence of tuberculosis, a fact that has been appreciated since the early 20 th century. The majority of the world's adolescents live in low and middle-income countries where tuberculosis remains common, and where they comprise one quarter of the population. Despite this, adolescents have not yet been addressed as a distinct population in tuberculosis policy or within tuberculosis treatment services, and emerging evidence suggests that current models of care do not meet their needs.This article reviews current knowledge about tuberculosis in adolescence with a focus on the management of infection and disease, including HIV co-infection and rifampicin-resistant tuberculosis. Recent progress in vaccine development is outlined and important directions for future research are highlighted. Search strategy and selection criteriaThis was a narrative review of the literature on adolescent tuberculosis, informed by expert opinion and clinical experience. We reviewed the English-and Spanish-language literature for studies on adolescent tuberculosis to identify case series documenting clinical presentation and treatment outcomes. We searched PubMed with the following string on 19August 2019: ('tuberculosis'[Title]) AND ('adolescent'[TIAB]). The search returned 210 results, of which 11 were eligible for inclusion (Table 1), and we identified three additional studies from reference lists, for a total of 14 studies. Studies reporting solely on prevalence or where data from adolescents was aggregated with those of younger children or adults were excluded. Data were extracted regarding major site(s) of disease, percent of adolescents with microbiologic confirmation, adverse drug reactions, and final treatment outcomes.

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Section: Rifampicin Resistant Tuberculosismentioning

confidence: 99%

Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

116

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“…However, none of these studies have included children. Recently, there is a case report of 14-year-old boy from Karakalpakstan treated successfully with the shorter regimen [58]. Long-term follow-up data to reliably account for relapses have yet to be generated.…”

Section: Duration Of Treatmentmentioning

confidence: 99%

Current therapies for the treatment of multidrug-resistant tuberculosis in children in India

Mukherjee

Lodha

Kabra

2017

Expert Opinion on Pharmacotherapy

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Introduction: Multidrug-resistant tuberculosis (MDR-TB) is a serious life threatening condition affecting children as well as adults worldwide. Timely diagnosis and effective treatment, both of which are complex in children, are the prerogatives for a favorable outcome.Areas covered: This review covers epidemiology, treatment regimen and duration, newer drugs and adverse events in children with MDR-TB. Special note has been made of epidemiology and principles of treatment followed in Indian children.Expert opinion: High index of suspicion is essential for diagnosing childhood MDR-TB. If there is high probability, a child can be diagnosed as presumptive MDR-TB and started on empiric treatment in consultation with experts. However, every effort should be made to confirm the diagnosis. Backbone of an effective MDR-TB regimen consists of four 2nd line anti-TB drugs plus pyrazinamide; duration being 18–24 months. The newer drugs delamanid and bedaquiline can be used in younger children if no other alternatives are available after consultation with experts. Wider availability of these drugs should be ensured for benefit to all concerned. More research is required for development of new and repurposed drugs to combat MDR-TB. Children need to be included in clinical trials for such life-saving drugs, so that nobody is denied the benefits.

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“…3 The successful use of the shorter regimen has been reported in a few children. 44 Although this regimen is considerably shorter, it still includes a SLI and seven different drugs. Therefore, for children under 15 years of age with non-severe and culture-negative disease, a modified pediatric regimen for 12 months without a SLI may be preferable.…”

Section: Shorter ("Bangladesh") Regimenmentioning

confidence: 99%

Treatment of Multidrug-Resistant Tuberculosis in Children and Adolescents

Chiang

Furin

2017

J Pediatr Infect Dis

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Although tens of thousands of children and adolescents become sick with multidrug-resistant tuberculosis (MDR-TB) each year, fewer than 1,500 cases documenting treatment have been reported in the literature. Children treated for MDR-TB tend to have excellent clinical outcomes, but they suffer from the adverse events associated with current management strategies. This article will review the recommendations, evidence base, and future directions for MDR-TB therapy in children and adolescents.

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Multidrug-Resistant Tuberculosis in Child Successfully Treated with 9-Month Drug Regimen

Cited by 8 publications

References 5 publications

Adolescent tuberculosis

Adolescent tuberculosis

Current therapies for the treatment of multidrug-resistant tuberculosis in children in India

Treatment of Multidrug-Resistant Tuberculosis in Children and Adolescents

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