Newer Drugs for Tuberculosis Prevention and Treatment in Children

Children suffer a huge and often an unrecognized burden of tuberculosis (TB) in endemic countries like India. Better data have improved the visibility of childhood TB, but the establishment of functional TB prevention and treatment programs for children remains challenging. Barriers to TB prevention include: 1) non-implementation of existing guidelines, 2) perceived inability to rule out active TB with fear of creating drug resistance and 3) limited local guidance on the use of preventive therapy after close contact with drug resistant TB. Barriers to TB treatment include: 1) diagnostic challenges in resource-limited settings, 2) presentation to maternal and child health (MCH) services with poor linkage to the TB control program and 3) limited local guidance on the treatment of children with likely drug resistant TB. The authors provide an overview of newer drugs used for TB prevention and treatment in children. They discuss new options for the treatment of latent TB infection (LTBI) and new or repurposed drugs used in the treatment of children with multidrug resistant (MDR)-TB. The background information provided describes the benefits, risks and feasibility of various treatment options, which should assist treatment decisions until updated World Health Organization (WHO) guidance becomes available.