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Short course chemotherapy for tuberculosis in children
R Padmini1, S Srinivasan, P Nalini
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Insights
Short course chemotherapy (SCC) for childhood tuberculosis is highly effective. This 6-9 month treatment regimen using isoniazid and rifampicin showed excellent results with minimal side effects in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Tuberculosis (TB) remains a significant global health challenge in children.
- Conventional chemotherapy for pediatric TB often requires prolonged treatment durations (18+ months).
- The need for shorter, effective treatment regimens is critical for improving adherence and outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of short course chemotherapy (SCC) for treating tuberculosis in children under 12 years old.
- To compare SCC outcomes with conventional, longer-duration chemotherapy.
- To assess the tolerability and side effects of SCC in pediatric patients.
Main Methods:
- A prospective study involving 83 newly diagnosed pediatric TB cases (< 12 years old).
- Patients received SCC, with treatment durations of 6-9 months for mild/moderate cases and 12 months for severe cases (meningitis, disseminated, miliary TB).
- Follow-up ranged from 1-3 years to monitor for disease recurrence and adverse events.
Main Results:
- No children exhibited evidence of active tuberculosis at the end of the follow-up period.
- The SCC regimen was well-tolerated, with only mild, transient side effects reported (hepatitis, vomiting, skin rash).
- SCC demonstrated high efficacy, with 100% of patients achieving a cure.
Conclusions:
- Short course chemotherapy (SCC) for 6-9 months, primarily using isoniazid and rifampicin, is highly effective for most pediatric tuberculosis cases.
- SCC offers significant advantages over conventional chemotherapy, including shorter duration and good tolerability.
- This treatment approach presents a promising alternative for managing childhood tuberculosis, potentially improving patient compliance and outcomes.
Abstract:
In order to determine the efficacy of short course chemotherapy (SCC) for tuberculosis in children, 83 newly diagnosed cases in children < 12 years old were given SCC and were prospectively followed for 1-3 years. Seventy-one cases were treated for 6-9 months as they had mild to moderate involvement. Twelve cases were treated for 12 months as they had meningitis (7), disseminated tuberculosis (2), or miliary tuberculosis (3). The results showed that none of the children, at the end of follow up, showed evidence of active tuberculosis. All children tolerated the drugs well, with side effects noticed being mild, namely transient hepatitis (4), vomiting (1), and skin rash (1). It is suggested that SCC for 6-9 months using isoniazid (INH) and rifampicin along with other drugs when necessary is highly effective in most cases of tuberculosis in children and has several advantages over conventional chemotherapy of 18 months or longer duration.