Short course chemotherapy in children suffering from drug resistant tuberculosis
https://doi.org/10.21292/2075-1230-2021-99-2-34-39
Abstract
The objective: to study the effect of short course chemotherapy regimens on treatment outcomes in children with drug resistant tuberculosis.
Subjects and methods. In 2017-2019, 31 children at the age from 3 to 17 years old, received short course chemotherapy which lasted for 12-15 months. Children of both genders were enrolled in the study, they all were new pulmonary tuberculosis cases with multiple drug resistance or at risk of MDR, with no history of previous treatment with reserve anti-tuberculosis drugs, and without severe concomitant diseases. Before the treatment was prescribed, all children underwent lung computed tomography additionally to general clinical and laboratory tests.
Results. The chemotherapy regimen for each child consisted of 4-6 drugs selected individually with the consideration of resistance pattern of the child or suspected index case. In all cases, the combination of drugs included fluoroquinolones (levofloxacin or moxifloxacin). Amikacin (67.7%), aminosalicylic acid (80.6%) and prothionamide (74.2%) were frequently prescribed. 54.8% of children received pyrazinamide and 48.4% – cycloserine. Given the limited lesions, only 16.1% of children received linezolid and 9.7% of children received bedaquiline. The main chemotherapy course made 13.2 ± 0.5 months (from 12 to 15 months depending on the form of tuberculosis and changes during treatment). The duration of the intensive phase made 4.8 ± 0.3 on the average. 2 (6.5 ± 4.4%) of 31 children developed adverse events requiring the cancellation of the drugs causing them.
Conclusion. This study has demonstrated satisfactory tolerability and good efficacy of these short course regimens for treatment of multiple drug resistant tuberculosis. No relapses of tuberculosis were reported.
About the Authors
N. I. Klevno
National Medical Research Center of Phthisiopulmonology and Infectious Diseases
Russian Federation
Russian Federation
Nadezhda I. Klevno, Doctor of Medical Sciences, Leading Researcher of Children and Adolescents Department
Build. 2, 4, Dostoevskiy St., Moscow, 127473
V. A. Аksenova
National Medical Research Center of Phthisiopulmonology and Infectious Diseases
Russian Federation
Russian Federation
Valentina A., Doctor of Medical Sciences, Professor, Head of Children and Adolescents Department
Build. 2, 4, Dostoevskiy St., Moscow, 127473
A. V. Kazakov
National Medical Research Center of Phthisiopulmonology and Infectious Diseases
Russian Federation
Russian Federation
Aleksey V. Kazakov, Candidate of Medical Sciences, Senior Researcher of Children and Adolescents Department
Build. 2, 4, Dostoevskiy St., Moscow, 127473
E. B. Kovalevskaya
National Medical Research Center of Phthisiopulmonology and Infectious Diseases
Russian Federation
Russian Federation
Elena B. Kovalevskaya, Junior Researcher of Children and Adolescents Department
Build. 2, 4, Dostoevskiy St., Moscow, 127473
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Review
For citations:
Klevno N.I., Аksenova V.A., Kazakov A.V., Kovalevskaya E.B. Short course chemotherapy in children suffering from drug resistant tuberculosis. Tuberculosis and Lung Diseases. 2021;99(2):34-39. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-2-34-39
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