Tuberculosis Research Centre (Indian Council of Medical Research), Chennai, India.
Indian J Pediatr. 2011 Apr;78(4):435-42. doi: 10.1007/s12098-010-0304-x. Epub 2010 Dec 17.
Tuberculosis (TB) is among the top 10 causes of death among children worldwide. Recent reports suggest that the currently recommended dosages of first-line anti-TB drugs are not adequate in children, particularly younger children. The objective of this review was to synthesize available pharmacokinetic data of anti-TB drugs in children from different settings that would help determine optimal doses of anti-TB drugs, in order to provide evidence-based recommendations. A PubMed database was searched from 1970 to present using the terms rifampicin, isoniazid, pyrazinamide, ethambutol, pharmacokinetics, HIV, TB, nutrition and children. References from identified articles were also reviewed and abstract from recent meetings were included. Available pharmacokinetic data from different settings suggest that age, nutritional status, HIV infection and gene polymorphisms in drug metabolising enzymes could significantly influence the pharmacokinetics of first-line anti-TB drugs. However, most of the pharmacokinetic studies conducted so far in children have failed to associate drug concentrations with treatment outcomes. Hence, more studies to examine the relationship between drug pharmacokinetics and response to anti-TB treatment are required. Studies to examine the impact of nutritional status and HIV infection on the pharmacokinetics of anti-TB drugs in children are needed.
结核病（TB）是全球儿童十大死因之一。最近的报告表明，目前推荐的一线抗结核药物剂量在儿童中，特别是在年幼的儿童中并不足够。本综述的目的是综合来自不同环境的儿童中抗结核药物的可用药代动力学数据，以帮助确定抗结核药物的最佳剂量，从而提供循证建议。使用利福平、异烟肼、吡嗪酰胺、乙胺丁醇、药代动力学、HIV、TB、营养和儿童等术语，从 1970 年至今在 PubMed 数据库中进行了检索。还回顾了已确定文章的参考文献，并纳入了最近会议的摘要。来自不同环境的可用药代动力学数据表明，年龄、营养状况、HIV 感染和药物代谢酶中的基因多态性可能会显著影响一线抗结核药物的药代动力学。然而，迄今为止在儿童中进行的大多数药代动力学研究未能将药物浓度与治疗结果联系起来。因此，需要更多的研究来检查药物药代动力学与抗结核治疗反应之间的关系。需要研究营养状况和 HIV 感染对儿童抗结核药物药代动力学的影响。
