Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Clinical Building, Room 0085, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg, South Africa.
Am J Respir Crit Care Med. 2012 Nov 15;186(10):953-64. doi: 10.1164/rccm.201206-1001CI. Epub 2012 Sep 13.
The management of children with drug-resistant tuberculosis (DR-TB) is challenging, and it is likely that in many places, the roll-out of molecular diagnostic testing will lead to more children being diagnosed. There is a limited evidence base to guide optimal treatment and follow-up in the pediatric population; in existing DR-TB guidelines, the care of children is often relegated to small "special populations" sections. This article seeks to address this gap by providing clinicians with practical advice and guidance. This is achieved through review of the available literature on pediatric DR-TB, including research studies and international guidelines, combined with consensus opinion from a team of experts who have extensive experience in the care of children with DR-TB in a wide variety of contexts and with varying resources. The review covers treatment initiation, regimen design and treatment duration, management of comorbid conditions, treatment monitoring, adverse events, adherence promotion, and infection control, all within a multidisciplinary environment.
儿童耐多药结核病（DR-TB）的管理极具挑战，而且在许多地方，分子诊断检测的推出可能会导致更多儿童被诊断出来。目前针对儿科人群，指导最佳治疗和随访的证据有限；在现有的耐多药结核病指南中，儿童的护理往往被归入小型的“特殊人群”部分。本文旨在通过为临床医生提供实用的建议和指导来填补这一空白。这是通过审查有关儿科 DR-TB 的现有文献来实现的，包括研究报告和国际指南，并结合了在各种环境和资源下，对儿童耐多药结核病护理具有丰富经验的专家团队的共识意见。该综述涵盖了治疗启动、方案设计和治疗持续时间、合并症的管理、治疗监测、不良事件、依从性促进和感染控制，所有这些都在多学科环境中进行。
