Huynh Julie, Thwaites Guy, Marais Ben J, Schaaf H Simon
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Nuffield Department of Medicine, Department of Tropical Medicine and Global Health, Oxford University, Oxford, United Kingdom.
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Nuffield Department of Medicine, Department of Tropical Medicine and Global Health, Oxford University, Oxford, United Kingdom.
Paediatr Respir Rev. 2020 Nov;36:33-43. doi: 10.1016/j.prrv.2020.02.002. Epub 2020 Feb 26.
Traditionally children have been treated for tuberculosis (TB) based on data extrapolated from adults. However, we know that children present unique challenges that deserve special focus. New data on optimal drug selection and dosing are emerging with the inclusion of children in clinical trials and ongoing research on age-related pharmacokinetics and pharmacodynamics. We discuss the changing treatment landscape for drug-susceptible and drug-resistant paediatric tuberculosis in both the most common (intrathoracic) and most severe (central nervous system) forms of disease, and address the current knowledge gaps for improving patient outcomes.
传统上，儿童结核病的治疗是基于从成人数据推断而来的数据。然而，我们知道儿童面临着独特的挑战，值得特别关注。随着儿童被纳入临床试验以及对年龄相关药代动力学和药效学的持续研究，关于最佳药物选择和剂量的新数据不断涌现。我们讨论了在最常见（胸腔内）和最严重（中枢神经系统）疾病形式中，药物敏感和耐药性小儿结核病治疗格局的变化，并阐述了当前改善患者预后方面的知识空白。
