Academic Department of Paediatrics, Imperial College London Department of Paediatric Infectious Diseases, Imperial College London NHS Healthcare Trust, United Kingdom.
Treatment Action Group, New York, New York.
Clin Infect Dis. 2015 Oct 15;61Suppl 3:S188-99. doi: 10.1093/cid/civ582.
Tuberculosis in children accounts for a significant proportion of the overall burden of disease, and yet for many years research into pediatric treatment has been neglected. Recently, there have been major developments in our understanding of pediatric tuberculosis, and a large number of studies are under way or planned. New drugs and regimens are being evaluated, and older drugs are being repurposed. Shorter regimens with potentially fewer side effects are being assessed for the treatment and prevention of both drug-susceptible and drug-resistant tuberculosis. It may be possible to tailor treatment so that children with less severe disease are given shorter regimens, and weekly dosing is under investigation for preventive therapy and for the continuation phase of treatment. The interaction with human immunodeficiency virus and the management of tuberculosis meningitis are also likely to be better understood. Exciting times lie ahead for pediatric tuberculosis, but much work remains to be done.
儿童结核病在疾病总负担中占很大比例,但多年来,儿科治疗的研究一直被忽视。最近,我们对儿童结核病的认识有了重大发展,并且正在进行或计划进行大量研究。正在评估新的药物和方案,并且正在重新利用旧的药物。正在评估具有潜在较少副作用的较短方案,以治疗和预防药物敏感性和耐药性结核病。有可能对治疗进行定制,使病情较轻的儿童接受较短的方案,并且正在研究每周一次给药,用于预防性治疗和治疗的继续阶段。与人类免疫缺陷病毒的相互作用以及结核性脑膜炎的管理也可能得到更好的理解。儿童结核病的前景令人兴奋,但仍有许多工作要做。