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Tuberculosis treatment in children: The changing landscape
Affiliation:1. Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam;2. Nuffield Department of Medicine, Department of Tropical Medicine and Global Health, Oxford University, Oxford, United Kingdom;3. Department of Infectious Diseases and Microbiology, The Children’s Hospital Westmead, Westmead, Australia;4. Discipline of Child and Adolescent Health, University of Sydney, The Children’s Hospital Westmead, Australia;5. Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia;6. Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;7. Tygerberg Hospital, Cape Town, South Africa;1. Salesi Children’s Hospital Foundation, Ancona, Italy;2. Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, and National Heart and Lung Institute, Imperial School of Medicine, London, UK;1. Department of Paediatrics, Subang Jaya Medical Centre, Malaysia;2. Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, UK;3. Respiratory Paediatrics, National Heart & Lung Institute, Imperial College London, London, UK;4. Department of Radiology, Subang Jaya Medical Centre, Malaysia;5. Diagnostic and Interventional Radiology, National Heart & Lung Institute, Imperial College London, UK;6. The Royal Brompton & Harefield NHS Foundation Trust, Sydney St, London SW3 6NP, UK;1. Disorders of Immunity and Respiration of the Pediatric Critical Patients Research Group, Institut de Recerca Hospital Sant Joan de Deu, Barcelona, Spain;2. Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu and University of Barcelona, Barcelona, Spain;3. Pediatric Intensive Care Unit Service, Pediatric Department, Hospital Universitari de Tarragona Joan XXIII, Institut Catala de la Salut Camp de Tarragona, Spain;4. Pediatric Intensive Care Unit, Paediatric Infectious Diseases Research Group, Institut Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, CIBERESP, Barcelona, Spain
Abstract: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.
Keywords:Multidrug-resistant tuberculosis  TB meningitis  Antituberculosis  Host-directed therapy
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