Consensus statement on the use of a four-month treatment regimen for drug susceptible tuberculosis in children (< 10 years of age) with uncomplicated disease
Endorsed by the Australian and New Zealand Paediatric Infectious Diseases (ANZPID) interest group of the Australasian Society of Infectious Diseases (ASID) and the National Tuberculosis Advisory Committee (NTAC) on behalf of the Communicable Diseases Network of Australia (CDNA)
DOI:
https://doi.org/10.33321/cdi.2022.46.85Keywords:
tuberculosis, treatmentAbstract
Disclaimer: The views expressed in this item are those of the individual authors, and do not necessarily represent the views of the Communicable Diseases Intelligence journal or the Australian Centre for Disease Control. While this Policy and Guidelines item was drafted with consideration to the then-available information on the condition(s) addressed within, it may not be complete and may not represent the currently understood best practice for the referenced condition(s). Readers are advised to refer to the most recent guidance on this matter, where such guidance exists and where its authoritativeness can be established. These guidelines do not replace the need for clinical judgment to be exercised for each individual circumstance, nor the necessity for expert advice to be obtained as appropriate.
In children aged between 3 months and < 10 years with non-severe TB (without immune compromise or suspicion of multidrug-, rifampicin, isoniazid, or pyrazinamide-resistant TB), a four-month treatment regimen (2HRZ(E)/2HR) should be used.
Non-severe TB is defined as peripheral lymph node disease (in isolation) or pulmonary TB confined to less than one lobe of the lung with no cavities, intra-thoracic lymph node involvement without radiologically visible or clinically significant airway obstruction, no signs of disseminated (miliary) TB and no complex pleural effusion.
The four-month treatment regimen can also be considered in children with minimal immune compromise or aged 10 –< 16 years, if non-severe TB is verified by an experienced clinician.
Endorsed by the Australian and New Zealand Paediatric Infectious Diseases (ANZPID) interest group of the Australasian Society of Infectious Diseases (ASID) and the National Tuberculosis Advisory Committee (NTAC) on behalf of the Communicable Diseases Network of Australia (CDNA).
Downloads
References
Dorman SE, Nahid P, Kurbatova EV, Phillips PPJ, Bryant K, Dooley KE et al. Four-month rifapentine regimens with or without moxifloxacin for tuberculosis. N Engl J Med. 2021;384(18):1705–18. doi: https://doi.org/10.1056/NEJMoa2033400.
Carr W, Kurbatova E, Starks A, Goswami N, Allen L, Winston C. Interim guidance: 4-month rifapentine-moxifloxacin regimen for the treatment of drug-susceptible pulmonary tuberculosis – United States, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(8):285–9. doi: https://doi.org/10.15585/mmwr.mm7108a1.
Turkova A, Wills GH, Wobudeya E, Chabala C, Palmer M, Kinikar A et al. Shorter treatment for nonsevere tuberculosis in African and Indian children. N Engl J Med. 2022;386(10):911–22. doi: https://doi.org/10.1056/NEJMoa2104535.
World Health Organization (WHO) Global Tuberculosis Programme. WHO Operational Handbook on Tuberculosis: Module 4: Treatment - Drug-Susceptible Tuberculosis Treatment. Geneva: WHO; 24 May 2022. Available from: https://www.who.int/publications/i/item/9789240050761.
WHO Global Tuberculosis Programme. WHO Operational Handbook on Tuberculosis: Module 5: Management of Tuberculosis in Children and Adolescents. Geneva: WHO; 17 March 2022. Available from: https://www.who.int/publications/i/item/9789240046832.
Chiang SS, Moscibrodzki P, Atieno VF, Bernays S, Bondarenko Y, Cruz AT et al. Caring for adolescents and young adults with tuberculosis or at risk of tuberculosis: consensus statement from an international expert panel. J Adolesc Health. 2023; in press.
Palmer M, Seddon JA, Goussard P, Schaaf HS. Diagnostic CXR Atlas for Tuberculosis in Children: a guide to chest X-ray interpretation. Paris: International Union Against Tuberculosis and Lung Disease; 24 March 2022. Available from: https://theunion.org/technical-publications/diagnostic-cxr-atlas-for-tuberculosis-in-children.
Published
How to Cite
License
Copyright (c) 2022 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
