Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
Paediatr Respir Rev. 2011 Mar;12(1):22-6. doi: 10.1016/j.prrv.2010.09.005. Epub 2010 Oct 15.
The World Health Organization has recently revised the recommended dosages of the main first-line anti-tuberculosis drugs for use in children. The recommended dosages and range of isoniazid, rifampicin, pyrazinamide and ethambutol have been increased from the previous recommended dosages. Ethambutol is now recommended for use in children of all ages including those of less than 5 years of age. This review explains the rationale for these recent revisions. Children require higher dosages than adults to achieve the same serum concentrations. Available data in HIV-uninfected children suggest that the revised dosages are within limits that have a very low risk of toxicity. An important challenge will be to examine the impact of higher dosages on clinical response, drug-drug interactions and risk of toxicity in HIV-infected children.
世界卫生组织最近修订了儿童一线抗结核药物的推荐剂量。异烟肼、利福平、吡嗪酰胺和乙胺丁醇的推荐剂量和范围均较以往有所增加。乙胺丁醇现在推荐用于所有年龄段的儿童，包括 5 岁以下的儿童。本文对这些最新修订的原理进行了解释。为了达到相同的血清浓度，儿童所需的剂量要高于成人。在未感染艾滋病毒的儿童中，现有数据表明，修订后的剂量在毒性风险非常低的范围内。一个重要的挑战是检验更高剂量对临床反应、药物相互作用和艾滋病毒感染儿童毒性风险的影响。
