title: Paediatric use of second-line anti-tuberculosis agents: a review.
abstract: Childhood multidrug-resistant tuberculosis (MDR-TB) is an emerging global epidemic. With the imminent roll-out of rapid molecular diagnostic tests, more children are likely to be identified and require treatment. As MDR-TB is resistant to the most effective first-line drugs, clinicians will have to rely on second-line medications which are less effective and often associated with more pronounced adverse effects than first-line therapy. Despite the fact that most of these agents were discovered many years ago, robust information is lacking regarding their pharmacokinetic and pharmacodynamic properties, adverse effects and drug interactions, especially in children. Children differ from adults in the way that drugs are administered, the manner in which they are metabolised and in the adverse effects experienced. The interaction of these drugs with human immunodeficiency virus infection and antiretroviral therapy is also poorly documented. This article reviews the available second-line drugs currently used in the treatment of MDR-TB in children and discusses medication properties and adverse effects while potential interactions with antiretroviral therapy are explored.
authors: Desmond Tutu TB Centre, Faculty of Health Sciences, Stellenbosch University, South Africa. jseddon@sun.ac.za
authors: James A
authors: JA
authors: Seddon
authors: Anneke C
authors: AC
authors: Hesseling
authors: Ben J
authors: BJ
authors: Marais
authors: Helen
authors: H
authors: McIlleron
authors: Charles A
authors: CA
authors: Peloquin
authors: Peter R
authors: PR
authors: Donald
authors: H Simon
authors: HS
authors: Schaaf
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000453:epidemiology; D000293:Adolescent; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D017408:Guidelines as Topic; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents