Traitement de la tuberculose

The treatment of tuberculosis in children has evolved towards a short course regimen based on 6 months therapy with isoniazid and rifampin supplemented during the first 2 months with pyrazinamide in the case of pulmonary tuberculosis due to susceptible organisms. In the presence of adult type tuberculosis (upper lobe infiltration and cavitation) or in case of increased risk of drug - resistant organisms, a fourth drug is added initially. Extra pulmonary tuberculosis is generally treated similarly to pulmonary disease, except disseminated disease and meningitis, which are treated during 9 to 12 months. The treatment of children co-infected by HIV is more complex due to increased risk of drug resistant organisms and by interaction between rifampin and anti-retroviral agents. Concerning latent tuberculosis infection, the association of isoniazid and rifampin for 3 months is recommended. The drug treatment of tuberculosis should be integrated in a global approach comprising the detection of new cases, organisation of the treatment and follow up of the child to ensure the completion of treatment.