Management of Multi-drug-resistant Tuberculosis in Children

Drug-resistant tuberculosis (DR-TB) has emerged as the biggest impediment to maintaining effective global tuberculosis control. The incidence and prevalence of paediatric DR-TB, as well as the risk of disease progression and transmission, are not as low in children as previously thought. Here, the authors review what is known about the diagnosis and management of childhood DR-TB, including preventive chemoprophylaxis and infection control in healthcare settings. Specifically, the authors point out the challenging but central role of drug susceptibility testing and review the concepts guiding the design of optimal treatment plans. The authors also address the issues surrounding directly observed therapy and patient monitoring in paediatric DR-TB. Lastly, the authors address the four pillars of optimal infection control, and provide guidance on how they could be implemented in clinical settings for children with DR-TB.