Concerns on the dosing of antitubercular drugs for children in RNTCP.

The Revised National Tuberculosis Control Program (RNTCP) has initiated provision of antitubercular therapy for children with strategy of patient-wise boxes for the 4 different weight bands (6- 10 kg; 11- 17 kg; 18- 25 kg; 26- 30 kg). We evaluated the dose of individual drugs delivered by this approach to children of varying weights. The following areas of concern were identified: underdosing of individual antitubercular drugs for many weights; lack of provision to modify doses when child gains weight and moves to another weight band; and, inappropriate formulations, particularly for infants. We conclude that the current dosing strategy used in RNTCP needs modification to prevent the significant risk of underdosing and undertreatment.