title: Caring for children with drug-resistant tuberculosis: practice-based recommendations.
abstract: The management of children with drug-resistant tuberculosis (DR-TB) is challenging, and it is likely that in many places, the roll-out of molecular diagnostic testing will lead to more children being diagnosed. There is a limited evidence base to guide optimal treatment and follow-up in the pediatric population; in existing DR-TB guidelines, the care of children is often relegated to small "special populations" sections. This article seeks to address this gap by providing clinicians with practical advice and guidance. This is achieved through review of the available literature on pediatric DR-TB, including research studies and international guidelines, combined with consensus opinion from a team of experts who have extensive experience in the care of children with DR-TB in a wide variety of contexts and with varying resources. The review covers treatment initiation, regimen design and treatment duration, management of comorbid conditions, treatment monitoring, adverse events, adherence promotion, and infection control, all within a multidisciplinary environment.
authors.affiliation: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Clinical Building, Room 0085, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg, South Africa. jseddon@sun.ac.za
authors.forename: James A
authors.initials: JA
authors.lastname: Seddon
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Furin
authors.forename: Marianne
authors.initials: M
authors.lastname: Gale
authors.forename: Hernan
authors.initials: H
authors.lastname: Del Castillo Barrientos
authors.forename: Rocío M
authors.initials: RM
authors.lastname: Hurtado
authors.forename: Farhana
authors.initials: F
authors.lastname: Amanullah
authors.forename: Nathan
authors.initials: N
authors.lastname: Ford
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Starke
authors.forename: H Simon
authors.initials: HS
authors.lastname: Schaaf
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D023801:Directly Observed Therapy; D016903:Drug Monitoring; D006801:Humans; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents