Chinese Academy of Science (CAS) Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.
Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China.
Front Cell Infect Microbiol. 2023 Jun 13;13:1183597. doi: 10.3389/fcimb.2023.1183597. eCollection 2023.
Tuberculosis (TB) is a major public health problem, with nearly 10 million new cases and millions of deaths each year. Around 10% of these cases are in children, but only a fraction receive proper diagnosis and treatment. The spread of drug-resistant (DR) strain of TB has made it difficult to control, with only 60% of patients responding to treatment. Multi-drug resistant TB (MDR-TB) is often undiagnosed in children due to lack of awareness or under-diagnosis, and the target for children's DR-TB treatment has only been met in 15% of goals. New medications such as bedaquiline and delamanid have been approved for treating DR-TB. However, due to age and weight differences, adults and children require different dosages. The availability of child-friendly formulations is limited by a lack of clinical data in children. This paper reviews the development history of these drugs, their mechanism of action, efficacy, safety potential problems and current use in treating DR-TB in children.
结核病(TB)是一个主要的公共卫生问题,每年有近 1000 万例新发病例和数百万人死亡。这些病例中约有 10%发生在儿童,但只有少数儿童得到了适当的诊断和治疗。耐多药(DR)结核菌株的传播使得控制变得更加困难,只有 60%的患者对治疗有反应。由于缺乏认识或诊断不足,儿童中经常漏诊耐多药结核病(MDR-TB),儿童耐 DR-TB 治疗的目标仅达到 15%。贝达喹啉和德拉马尼等新药物已被批准用于治疗耐多药结核病。然而,由于年龄和体重的差异,成人和儿童需要不同的剂量。由于缺乏儿童临床数据,适合儿童使用的制剂的供应有限。本文综述了这些药物的发展历史、作用机制、疗效、安全性、潜在问题以及目前在儿童耐多药结核病治疗中的应用。