Treatment for children with TB

Treatment of active tuberculosis (TB) in children is usually different from treatment of TB in adults. In children younger than 4 years, TB is more likely to spread beyond the lungs (extrapulmonary TB). It is also harder to get from children a sputum sample that grows TB bacteria.¹ So the doctor may assume that a child is infected with the same type of TB bacteria as the person who most likely infected him or her.

In general, TB treatment in children usually begins with 3 medicines instead of 4 because:

• The number of bacteria usually is small.
• It may be hard to determine if a child is having vision problems, which can be caused by ethambutol.

Children with TB usually take isoniazid, rifampin, and pyrazinamide for 2 months. Treatment then continues for at least 4 more months with isoniazid and rifampin. Vitamin B6 (pyridoxine) also may be recommended during TB treatment if the child is not eating a good diet or isn't getting enough nutrients. Directly observed therapy (DOT) is usually done to make sure that the child takes all of the medicine.

Additional medicines taken for a longer time may be needed for children:

• With extrapulmonary TB.
• Who are infected with TB and human immunodeficiency virus (HIV).
• Who are infected with TB bacteria that cannot be killed by 1 or more antibiotics.

A child taking ethambutol to treat a TB infection should have his or her vision checked every month.

Citations

1. American Thoracic Society, Centers for Disease Control and Prevention, Infectious Diseases Society of America (2003). Treatment of tuberculosis. American Journal of Respiratory and Critical Care Medicine, 167(4): 603-662.