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Successful Use of Infliximab and a Shortened Antibiotic Regimen in Pediatric Multidrug-resistant Tuberculous

Brenda Maria Toro1,2, Ana Dias Curado2,3, Tiago Proença Santos2,4

  • 1From the Department of Pediatrics, Hospital Santa Maria, Unidade Local de Saúde de Santa Maria, Lisbon Academic Medical Center (CAML), Lisbon, Portugal.

The Pediatric Infectious Disease Journal
|July 30, 2026
PubMed

Insights

Multidrug-resistant tuberculous meningitis in children can be treated with shorter, all-oral regimens. A 12-month treatment plan, including newer agents and Infliximab, was effective and managed toxicity in a pediatric case.

Area of Science:

  • Pediatric infectious diseases
  • Neurology
  • Pharmacology

Background:

  • Multidrug-resistant tuberculous meningitis (MDR-TBM) is a severe childhood illness.
  • Standard treatment duration is lengthy (18-24 months).
  • Neuropathic toxicity and paradoxical reactions are significant challenges.

Purpose of the Study:

  • To report a pediatric case of MDR-TBM managed with a shortened treatment regimen.
  • To highlight the successful use of Infliximab for managing paradoxical reactions.
  • To support the feasibility of shorter, all-oral regimens in select pediatric patients.

Main Methods:

  • Case report of a pediatric patient with MDR-TBM.
  • Treatment involved a 12-month all-oral regimen.
  • Infliximab was administered to control steroid-dependent paradoxical reactions.

Main Results:

  • Successful management of pediatric MDR-TBM with a 12-month regimen.
  • Severe neuropathic toxicity necessitated regimen shortening.
  • Infliximab effectively controlled paradoxical reactions.
  • The patient tolerated the all-oral regimen.

Conclusions:

  • Shorter, all-oral regimens may be viable for selected pediatric MDR-TBM cases.
  • Incorporating newer agents and targeted therapies like Infliximab is promising.
  • Careful monitoring for and management of toxicity are crucial.
Keywords:
infliximabmultidrug-resistant tuberculosisparadoxical reactionpediatricstuberculous meningitis

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