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Concerns on the dosing of antitubercular drugs for children in RNTCP

Rakesh Lodha1, P Ramesh Menon, S K Kabra

  • 1Department of Pediatrics, AIIMS, New Delhi 110 029, India. rakesh_lodha@hotmail.com

Indian Pediatrics
|October 25, 2008
PubMed

Insights

The Revised National Tuberculosis Control Program

Area of Science:

  • Pediatric tuberculosis treatment
  • Pharmacokinetics and pharmacodynamics

Background:

  • The Revised National Tuberculosis Control Program (RNTCP) uses weight-banded patient-wise boxes for pediatric antitubercular therapy.
  • Current RNTCP strategy involves four weight bands: 6-10 kg, 11-17 kg, 18-25 kg, and 26-30 kg.

Purpose of the Study:

  • To evaluate the actual dose of individual antitubercular drugs delivered to children across different weight bands using the RNTCP strategy.
  • To identify potential discrepancies and risks associated with the current pediatric dosing approach.

Main Methods:

  • Analysis of drug dosages administered to children within the defined weight bands under the RNTCP.
  • Comparison of delivered doses against recommended pediatric tuberculosis treatment guidelines.
  • Assessment of formulation suitability for different age groups, particularly infants.

Main Results:

  • Significant underdosing of individual antitubercular drugs was observed for children across various weights within the RNTCP strategy.
  • The fixed weight-band approach fails to account for weight fluctuations, leading to suboptimal dosing as children gain weight.
  • Inappropriate drug formulations were identified, posing challenges for accurate and safe administration, especially in infants.

Conclusions:

  • The current RNTCP antitubercular drug dosing strategy for children requires modification to mitigate the substantial risk of underdosing and undertreatment.
  • Adjustments are necessary to ensure accurate and weight-appropriate drug delivery, particularly for vulnerable pediatric populations.
  • Improved dosing strategies and formulations are crucial for effective pediatric tuberculosis management.

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