Treatment regimens

All TB drugs are dispensed by the TB officer Monday to Friday 9-4pm
Refer all patients requiring treatment and prophylaxis to the TB officer on Ward 3A

The WHO has recently (2010) revised their treatment dosages for first line medicines for paediatric TB. These are as follows:

Rifampicin (R)
15mg/kg/d (10-20mg/kg/d)

Isoniazid (H)
10mg/kg/d (10-15mg/kg/d)

Pyrazinamide (Z)
35mg/kg/d (30-40mg/kg/d)

Ethambutol (E)
20mg/kg/d (15-25mg/kg/d)

We generally use a fixed drug combinations (FDC) to treat TB

It is important to monitor the child's weight at every clinic visit and to adjust drug doses accordingly. Many children rapidly gain weight after initiation of TB treatment.

Treatment duration

WHO published guidelines (2010) for the duration of treatment in paediatric TB as follows:

Site	HRZE - duration	HR - duration	Total length
TB meningitis, miliary TB, osseous - spine, joints	2 months	10 months	12 months
Pulmonary TB, TB lymphadenitis All other types of TB	2 months	4 months	6 months

Prednisolone

Used in the treatment of TBM and TB pericarditis and occasionally in large pleural effusions that fail to resolve.
Commence at the start of treatment, treat at 2mg/kg for two weeks and then taper over 2 weeks (1mg/kg for one week and 0.5mg/kg for one week) before stopping.

Pyridoxine

Pyridoxine (vitamin B6) protects against isoniazid-induced peripheral neuropathy. Pyridoxine is recommended for all children on TB treatment and IPT. The recommended dose is 25 mg/ day until treatment is completed

Follow-up Paediatric TB

review every month for three months and then at 6 months