National Institute for Research in Tuberculosis (Indian Council of Medical Research), Mayor Sathyamoorthy Road, Chetpet, Chennai, 600 031, India.
Indian J Pediatr. 2019 Aug;86(8):714-716. doi: 10.1007/s12098-019-02923-6. Epub 2019 Mar 28.
Multidrug-resistant tuberculosis (MDR TB) has become a major global health concern and is also an issue in children. Children with MDR TB need longer duration of treatment with multiple drugs. The MDR TB treatment regimen usually comprises of a fluoroquinolone, an aminoglycoside, ethionamide, cycloserine, pyrazinamide and ethambutol. In the absence of pediatric friendly tablets/formulations, in most cases the adult tablets are either crushed or broken. This is likely to lead to inaccurate dosing. Very limited information is available on the pharmacokinetics of second-line anti-TB drugs in children with MDR TB, except for few studies from South Africa and one from India. Drugs such as linezolid, clofazimine are also being considered for the treatment of MDR TB in children. However, their pharmacokinetics is not known in the pediatric population. It is important to generate pharmacokinetic studies of drugs used to treat MDR TB in children in different settings, which would provide useful information on the adequacy of drug doses.
耐多药结核病（MDR-TB）已成为一个主要的全球卫生关注问题，也是儿童中的一个问题。患有耐多药结核病的儿童需要用多种药物进行更长时间的治疗。耐多药结核病的治疗方案通常包括氟喹诺酮类、氨基糖苷类、乙胺丁醇、环丝氨酸、吡嗪酰胺和乙硫异烟胺。由于缺乏适合儿童的片剂/配方，在大多数情况下，成人片剂要么被压碎要么被掰开。这很可能导致剂量不准确。除了来自南非的少数研究和来自印度的一项研究外，关于耐多药结核病儿童二线抗结核药物的药代动力学的信息非常有限。利奈唑胺、氯法齐明等药物也被考虑用于儿童耐多药结核病的治疗。然而，它们在儿科人群中的药代动力学尚不清楚。在不同环境中为儿童治疗耐多药结核病而使用的药物进行药代动力学研究非常重要，这将为药物剂量的充足性提供有用的信息。
