title: Adverse effects of oral second-line antituberculosis drugs in children.
abstract: BACKGROUND
  Increasing numbers of children with drug-resistant tuberculosis are accessing second-line antituberculosis drugs; these are more toxic than first-line drugs. Little is known about the safety of new antituberculosis drugs in children. Knowledge of adverse effects, and how to assess and manage these, is important to ensure good adherence and treatment outcomes.
  
  
  METHODS
  A Pubmed search was performed to identify articles addressing adverse effects of second-line antituberculosis drugs; a general search was done for the new drugs delamanid and bedaquiline. This review discusses adverse effects associated with oral second-line antituberculosis drugs. The spectrum of adverse effects caused by antituberculosis drugs is wide; the majority are mild or moderate, but these are important to manage as it could lead to non-adherence to treatment. Adverse effects may be more common in HIV-infected than in HIV-uninfected children.
  
  
  CONCLUSIONS
  Although children may experience fewer adverse effects from oral second-line antituberculosis drugs than adults, evidence from prospective studies of the incidence of adverse events in children is limited. Higher doses of second-line drugs, new antituberculosis drugs, and new drug regimens are being evaluated in children: these call for strict pharmacovigilance in children treated in the near future, as adverse effect profiles may change.
authors.affiliation: a Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa.
authors.forename: H Simon
authors.initials: HS
authors.lastname: Schaaf
authors.affiliation: b Department of Paediatric Pneumology and Immunology , Charité, Universitätsmedizin Berlin , Berlin , Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Thee
authors.affiliation: a Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa.
authors.forename: Louvina
authors.initials: L
authors.lastname: van der Laan
authors.affiliation: a Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa.
authors.forename: Anneke C
authors.initials: AC
authors.lastname: Hesseling
authors.affiliation: a Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Garcia-Prats
mesh_terms: D000367:Age Factors; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D064687:Diarylquinolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D015658:HIV Infections / Q000150:complications; D006801:Humans; D009593:Nitroimidazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010080:Oxazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D064687:Diarylquinolines; D009593:Nitroimidazoles; C516022:OPC-67683; D010080:Oxazoles; C493870:bedaquiline
keywords: Adverse effects; antituberculosis drugs; children; multidrug-resistant; tuberculosis