Two pediatric cases of multidrug-resistant tuberculosis treated with linezolid and moxifloxacin.
We report here 2 pediatric cases of multidrug-resistant (MDR) tuberculosis (TB) that were observed in Italy. Both families came from an Eastern European country, which is notably an area with a high prevalence of MDR TB. An increase of new cases of MDR TB in developed countries is expected over the next years because of migratory flow, and specific measures and strategies need to be taken to prevent the propagation and dissemination of MDR TB. An efficacious treatment including linezolid and moxifloxacin was administered for 13 months in 1 case. No adverse reactions were detected during close child monitoring. Linezolid and newer fluoroquinolones such as moxifloxacin have been reported to be effective for MDR-TB treatment in adults. On the contrary, there is limited available evidence regarding the effectiveness and safety of these drugs in infants and children with MDR TB. The use of second-line drugs not approved for use in children may be necessary to treat a life-threatening disease such as MDR TB, but it requires careful monitoring to quickly recognize the occurrence of dose- and duration-dependent adverse drug reactions.
Pinon
Michele
M
Clinic of Infectious Diseases, Department of Pediatrics, University of Turin, Regina Margherita Children's Hospital, Turin, Italy. michele.pinon@gmail.com
Scolfaro
Carlo
C
Bignamini
Elisabetta
E
Cordola
Giorgio
G
Esposito
Irene
I
Milano
Rosangela
R
Mignone
Federica
F
Bertaina
Chiara
C
Tovo
Pier-Angelo
PA
D000081:Acetamides / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001372:Aza Compounds / Q000627:therapeutic use*; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D005260:Female; D024841:Fluoroquinolones; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007558:Italy; D000069349:Linezolid; D008297:Male; D008826:Microbial Sensitivity Tests; D008966:Moldova / Q000208:ethnology; D000077266:Moxifloxacin; D023303:Oxazolidinones / Q000627:therapeutic use*; D011804:Quinolines / Q000627:therapeutic use*; D012383:Romania / Q000208:ethnology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy*
D000081:Acetamides; D000995:Antitubercular Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D023303:Oxazolidinones; D011804:Quinolines; D000069349:Linezolid; D000077266:Moxifloxacin