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Published on: September 5, 2017
Two cases of pre-extensively drug resistant tuberculosis in children in Indonesia
Heda Melinda Nataprawira1, Indah Septiane1, Sri Sudarwati1
1Department of Child Health, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Indonesia.
Insights
Treatment for pre-extensively drug-resistant tuberculosis (pre-XDR-TB) in children is challenging. Two pediatric cases of pre-XDR-TB showed positive outcomes with individualized treatment, highlighting the need for careful monitoring.
Area of Science:
- Pediatric infectious diseases
- Mycobacterial infections
- Antimicrobial resistance
Background:
- Pre-extensively drug-resistant tuberculosis (pre-XDR-TB) is defined as resistance to isoniazid and rifampicin plus fluoroquinolone or second-line injectable drugs.
- Limited data exists on pediatric pre-XDR-TB, with treatment often individualized due to guideline gaps and new drug unavailability.
Observation:
- Two pediatric cases of pre-XDR-TB were treated with individualized regimens.
- The children responded well to their respective treatment plans.
Findings:
- Individualized treatment regimens can be effective for pediatric pre-XDR-TB.
- Successful treatment requires careful consideration of drug susceptibility patterns.
Implications:
- These findings suggest that tailored treatment approaches may improve outcomes for children with pre-XDR-TB.
- Close monitoring for adverse drug reactions is crucial due to the long duration and toxicity of treatments.
Abstract:
Few reports are available on children with pre-extensively drug-resistant tuberculosis (pre-XDR-TB), which is defined as Mycobacterium tuberculosis resistant to both isoniazid and rifampicin plus resistance to either a fluoroquinolone or a second-line injectable drug. Pre-XDR-TB treatment for children usually has been individualized based on drug susceptibility test (DST) results, but treatment remains challenging due to the lack of studies based on existing treatment guidelines in children and lack of availability of the new drugs. We report two cases of pre-XDR-TB in children who have responded well to individualized treatment regimens. Because toxic drugs are used for long duration, close monitoring of adverse drug reactions is important.
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