S2k-Leitlinie zur Diagnostik, Prävention und Therapie der Tuberkulose im Kindes- und Jugendalter

Abstract

Recently, epidemiological data shows an increase of childhood tuberculosis in Germany. In addition to this, drug resistant tuberculosis becomes more frequent. Therefore, diagnosis, prevention and therapy in childhood and adolescence remain a challenge. Adult guidelines do not work for children, as there are age specific differences in manifestation, risk of progression and diagnostic as well as therapeutic pathways.The German Society for Pediatric Infectious Diseases (DGPI) has initiated a consensus-based (S2k) process and completed a paediatric guideline in order to improve and standardize care for children and adolescents with tuberculosis exposure, infection or disease.Updated dosage recommendations take age dependant pharmacokinetics in the treatment of drug sensitive but also drug resistant tuberculosis in account. In addition to this, there is a detailed chapter on perinatal exposure and disease as well as extrapulmonary manifestations.

Tuberculosis in Pregnancy – a Summary

“…Further diagnostics in the newborn are mandatory in these cases. Because prompt initiation of anti-tuberculosis therapy is of crucial importance and anti-tuberculosis four-drug therapy should be initiated whenever TB is suspected 45 .…”

“…Asymptomatic newborns with relevant tuberculosis exposure should receive prophylactic therapy with INH and pyridoxine 45 .…”

Influence of age, sex and hospitalisation on the administration of tuberculosis medication: an evaluation of routine data from a German health insurer

“…Compliance with therapy standards is essential to achieve the goals of this End TB Strategy [ 7 , 8 ]. In line with WHO guidelines [ 9 ], consensus-based S2 standards for the treatment of TB in adults and in children [ 6 , 10 ] were developed in Germany to specify the ideal doses and treatment durations for both the conventional form of TB and for special drug-resistant forms and specific patient groups [ 11 ].…”

Fallbericht: Abdominelle und pulmonale Tuberkulose bei einem 6 Jahre alten Mädchen aus Indien

“…Zunehmende Migrationsbewegungen aus Gebieten mit hohen Infektionszahlen konfrontieren die westlichen Nationen mit steigenden Erkrankungszahlen und stellen sie vor diagnostische und therapeutische Herausforderungen. So sind in Deutschland seit 2015 erstmals wieder ansteigende Infektionsmeldungen für Tuberkulose zu verzeichnen (7). Um eine unbemerkte Krankheitsprogredienz und somit die Gefahr der weiteren Verbreitung zu verringern, bedarf es einer gesteigerten Aufmerksamkeit für diese Erkrankung.…”

“…Sensitivität und Zahl der korrekten Diagnosen insbesondere bei kindlicher TB in den letzten Jahren deutlich gesteigert werden (6). Die mikrobiologische Kultur gilt jedoch nach wie vor als Goldstandard in der TB-Diagnostik (7).…”