Treatment of tuberculosis infection in children

Expert Rev Anti Infect Ther. 2018 Sep;16(9):695-708. doi: 10.1080/14787210.2018.1513324. Epub 2018 Sep 7.

Abstract

Identifying and treating children with tuberculosis (TB) infection in both low and high-TB burden settings will decrease the incidence of TB disease worldwide. Areas covered: This review covers each of the available TB infection treatment options for children based on effectiveness, safety, tolerability and treatment completion rates. Six to 9 months of daily administered isoniazid is no longer the treatment of choice for many children with TB infection. Shorter, rifamycin based, TB infection treatment regimens are effective, safe and easier for children to complete. Fluroquinolone-based regimens are recommended for the treatment of children infected by a source case with drug-resistant TB. Directly observed therapy (DOT) programs improve childhood TB infection treatment completion rates. Expert commentary: As shorter, rifamycin-based, TB infection treatment regimens offer superior treatment success rate in both adults and children; the widespread use of these regimens has huge potential to decrease the burden of TB disease worldwide. The implementation of these programs will involve improving patient access to the medications, decreasing their cost to the patient, and the use of novel electronic methods to document patient treatment completion.

Keywords: Tuberculosis infection; directly observed preventive therapy; latent tuberculosis infection.

Publication types

  • Review

MeSH terms

  • Adult
  • Animals
  • Antitubercular Agents / administration & dosage*
  • Antitubercular Agents / adverse effects
  • Child
  • Directly Observed Therapy / methods
  • Drug Administration Schedule
  • Global Health
  • Health Services Accessibility
  • Humans
  • Incidence
  • Time Factors
  • Treatment Outcome
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology
  • Tuberculosis / microbiology
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Tuberculosis, Multidrug-Resistant / microbiology

Substances

  • Antitubercular Agents