Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Expert Rev Clin Pharmacol. 2023 Jan;16(1):5-15. doi: 10.1080/17512433.2023.2148653. Epub 2022 Nov 27.
According to the latest report from the World Health Organization (WHO), approximately 10.0 million people fell ill with tuberculosis (TB) in 2020, 12% of which were children aged under 15 years. There is very few experience on treatment of multi-drug resistant (MDR)-TB in pediatrics.
The aim of this review is to analyze and summarize therapeutic options available for children experiencing MDR-TB. We also focused on management of MDR-TB prophylaxis.
The therapeutic management of children with MDR-TB or MDR-TB contacts is complicated by a lack of knowledge, and the fact that many potentially useful drugs are not registered for pediatric use and there are no formulations suitable for children in the first years of life. Furthermore, most of the available drugs are burdened by major adverse events that need to be taken into account, particularly in the case of prolonged therapy. A close follow-up with a standardized timeline and a comprehensive assessment of clinical, laboratory, microbiologic and radiologic data is extremely important in these patients. Due to the complexity of their management, pediatric patients with confirmed or suspected MDR-TB should always be referred to a specialized center.
根据世界卫生组织（WHO）的最新报告，2020 年约有 1000 万人患有结核病（TB），其中 12%为 15 岁以下儿童。儿科耐多药（MDR）-TB 的治疗经验非常有限。
本综述旨在分析和总结儿童 MDR-TB 的治疗选择。我们还重点关注 MDR-TB 预防的管理。
由于缺乏知识，儿童 MDR-TB 或 MDR-TB 接触者的治疗管理变得复杂，许多潜在有用的药物尚未注册用于儿科用途，并且在生命的最初几年中没有适合儿童的制剂。此外，大多数可用的药物都存在重大不良反应，需要加以考虑，尤其是在长期治疗的情况下。在这些患者中，密切的随访、标准化的时间表以及对临床、实验室、微生物学和影像学数据的全面评估非常重要。由于其管理的复杂性，确诊或疑似 MDR-TB 的儿科患者应始终转介至专门中心。
