PT  - JOURNAL ARTICLE
AU  - Drobac, Peter C.
AU  - Mukherjee, Joia S.
AU  - Joseph, J. Keith
AU  - Mitnick, Carole
AU  - Furin, Jennifer J.
AU  - del Castillo, Hernán
AU  - Shin, Sonya S.
AU  - Becerra, Mercedes C.
TI  - Community-Based Therapy for Children With Multidrug-Resistant Tuberculosis
AID  - 10.1542/peds.2005-2235
DP  - 2006 Jun 01
TA  - Pediatrics
PG  - 2022--2029
VI  - 117
IP  - 6
4099  - http://pediatrics.aappublications.org/content/117/6/2022.short
4100  - http://pediatrics.aappublications.org/content/117/6/2022.full
SO  - Pediatrics2006 Jun 01; 117
AB  - OBJECTIVES. The goals were to describe the management of multidrug-resistant tuberculosis among children, to examine the tolerability of second-line antituberculosis agents among children, and to report the outcomes of children treated for multidrug-resistant tuberculosis in poor urban communities in Lima, Peru, a city with high tuberculosis prevalence.METHODS. A retrospective analysis of data for 38 children <15 years of age with multidrug-resistant tuberculosis, either documented with drug sensitivity testing of the child's tuberculosis isolate or suspected on the basis of the presence of clinical symptoms for a child with a household contact with documented multidrug-resistant tuberculosis, was performed. All 38 children initiated a supervised individualized treatment regimen for multidrug-resistant tuberculosis between July 1999 and July 2003. Each child received 18 to 24 months of therapy with ≥5 first- or second-line drugs to which their Mycobacterium tuberculosis strain was presumed to be sensitive.RESULTS. Forty-five percent of the children had malnutrition or anemia at the time of diagnosis, 29% had severe radiographic findings (defined as bilateral or cavitary disease), and 13% had extrapulmonary disease. Forty-five percent of the children were hospitalized initially because of the severity of illness. Adverse events were observed for 42% of the children, but no events required suspension of therapy for >5 days. Ninety-five percent of the children (36 of 38 children) achieved cures or probable cures, 1 child (2.5%) died, and 1 child (2.5%) defaulted from therapy.CONCLUSIONS. Multidrug-resistant tuberculosis disease among children can be treated successfully in resource-poor settings. Treatment is well tolerated by children, and severe adverse events with second-line agents are rare.