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A High-throughput Compatible Assay to Evaluate Drug Efficacy against Macrophage Passaged Mycobacterium tuberculosis
Published on: March 24, 2017
Antituberculosis drugs in children
H S Schaaf1, A J Garcia-Prats1, P R Donald1
1Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Insights
Pediatric tuberculosis (TB) requires better diagnosis and treatment. Understanding drug pharmacokinetics and pharmacodynamics is crucial for optimizing anti-TB drug dosing and developing child-friendly formulations to reduce childhood TB mortality.
Area of Science:
- Pediatric infectious diseases
- Pharmacology
- Global health
Background:
- Tuberculosis (TB) poses a significant global health risk to children, characterized by underdiagnosis and high rates of morbidity and mortality.
- Effective management strategies include active contact tracing for preventive therapy and prompt diagnosis and treatment of both drug-susceptible and drug-resistant TB.
Purpose of the Study:
- To review available antituberculosis drugs, focusing on their pharmacokinetic and pharmacodynamic properties in children.
- To provide a rationale for current pediatric dosing recommendations for anti-TB drugs.
- To highlight the need for further research to optimize pediatric TB treatment.
Main Methods:
- Literature review of existing antituberculosis drugs.
- Analysis of pharmacokinetic and pharmacodynamic data relevant to pediatric populations.
- Discussion of current dosing strategies and knowledge gaps.
Main Results:
- Limited pharmacokinetic data and few child-friendly formulations exist for pediatric anti-TB drugs.
- Knowledge gaps persist regarding the pharmacodynamics of these drugs in children.
- Current dosing recommendations are based on available, albeit limited, pediatric data.
Conclusions:
- Optimizing the treatment of pediatric tuberculosis necessitates further pharmacokinetic and pharmacodynamic studies for both existing and novel anti-TB drugs.
- Development of child-friendly formulations is essential for improving treatment adherence and outcomes in children.
- Addressing these research needs is critical to reduce mortality and morbidity associated with childhood TB.
Abstract:
Tuberculosis (TB) remains a global threat to children, as it often goes undiagnosed and leads to high morbidity and mortality. Active contact tracing leading to initiation of preventive therapy and early diagnosis with immediate effective treatment, whether it is drug-susceptible or drug-resistant TB, could reduce mortality and morbidity. In order to achieve this it is necessary to understand the currently available drugs, their role in treatment, their doses, and adverse effects. However, there is still limited pharmacokinetic data on antituberculosis drugs in children, few child-friendly formulations, and knowledge gaps regarding their pharmacodynamics. A discussion of the available antituberculosis drugs is presented, with a focus on their pharmacokinetics and pharmacodynamics, to provide reasoning for the currently recommended doses for children. More pharmacokinetic and pharmacodynamics studies, for both existing and novel drugs, are urgently needed to optimize dosing of antituberculosis drugs in children and for development of child-friendly formulations.
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