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Epidemiology and management of childhood multidrug-resistant tuberculosis

H Simon Schaaf* and James A Seddon

Multidrug-resistant tuberculosis (TB) in children is mainly caused by transmission of drug-resistant strains causing infection and disease (i.e., primary drug-resistant TB) and, therefore, follows adult multidrug-resistant TB trends. Diagnosis is made by culture and phenotypic or genotypic drug susceptibility testing, either from the child’s or the adult source case’s Mycobacterium tuberculosis isolate. Treatment is mainly with second-line anti-TB drugs, building a regimen with four effective drugs; the principles of management are the same as for adults. Monitoring for adverse events is important as second-line drugs are more toxic than first-line treatment. With early diagnosis and treatment, outcome is better than in adults. New drugs and drug combinations are in development and should also be evaluated in children