Infectious Management of TB in pediatrics

Management of tuberculosis in pediatrics The standard regimen consists of: The intensive phase with ۳-۴ drugs (isoniazid, rifampin [also known as rifampicin outside the United States], and pyrazinamide, with or without ethambutol) for ۲ months. The continuation phase with isoniazid plus rifampin for ۲-۱۰ months. The recommended duration varies by age and clinical presentation. Give continuation phase regimen for ۲ months in children aged ۳ months to ۱۶ years with nonsevere pulmonary TB or tuberculous peripheral lymphadenitis, without HIV infection or severe acute malnutrition or history of TB treatment in previous ۲ years. Give continuation phase regimen for ۴ months for most other forms of TB. Give continuation phase regimen for ۱۰ months for tuberculous meningitis or osteoarticular tuberculosis. For treatment of drug-resistant TB: Treatment options are determined by the resistance pattern of the causal organism in patients with multidrug-resistant TB (MDR TB) or extensively drug-resistant TB (XDR TB). MDR and XDR TB should be managed in consultation with an infectious disease/tuberculosis expert. For children and adolescents aged ۳ months to ۱۶ years: The intensive phase consists of isoniazid, rifampin, pyrazinamide, and ethambutol for ۲ months. The continuation phase consists of isoniazid plus rifampin for ۴ months. If tuberculosis meningitis is presumed or confirmed: The preferred treatment is a ۱۲-month standard-dose treatment regimen, consisting of and intensive phase with isoniazid, rifampin, pyrazinamide, ethambutol for ۲ months and a continuation phase with isoniazid plus rifampin for ۱۰ months. For all other forms of extrapulmonary TB (excluding peripheral lymph node TB, tuberculosis meningitis, and osteoarticular TB), use a ۶-month treatment regimen consisting of an intensive phase with isoniazid, rifampin, and pyrazinamide, with or without ethambutol for ۲ months and a continuation phase with isoniazid plus rifampin for ۴ months.