The use of reserve drugs in the chemotherapy of children and adolescents with tuberculosis

Abstract

Introduction. The incidence of tuberculosis in children and adolescents is considered one of the most significant epidemiological indicators, which reflects the overall epidemic situation for tuberculosis. An urgent problem is the fact that the effectiveness of treatment of tuberculosis with MDR/XDR MBT in children and adolescents is not reflected in official statistics, and the tolerability of new anti-tuberculosis drugs in children with tuberculosis is not sufficiently studied at present. One of the drugs that can be used in the treatment of MDR-TB in children is linezolid. Objective. to evaluate the safety and efficacy of linezolid in chemotherapy regimens for drug-resistant tuberculosis in children. Results. in the structure of clinical forms of infiltrative tuberculosis — (32.0%), the primary tuberculosis complex was detected in 8 people (16.0%), TB of intra-thoracic lymph nodes also in 8 people (16.0%). MBT resistance to cycloserine and linezolid has not been reported in any patients. All patients received linezolid (100%). The development of undesirable side effects was observed in 14 people (28.0%). Linezolid caused in 3 people (6.0%) (adolescents 13 — 17 years old) undesirable adverse reactions of the type of polyneuropathy. The cessation of bacterial excretion was observed after 1 month in 100 % of cases. All children showed positive clinical dynamics and normalization of blood parameters in the period from 2 to 6 months of treatment. Positive radiological dynamics were also observed in the period from 2 to 6 months of treatment in the form of closure of the decay cavities, compaction, calcification and resorption of foci. Conclusion. Linezolid is a promising drug in children with tuberculosis who need the use of reserve drugs, since clinical efficacy is noted, MBT resistance is rarely developed, and the frequency of undesirable side reactions of regimens with the inclusion of linezolid does not exceed the frequency of those when prescribing regimens without the inclusion of linezolid