About half a million children are diagnosed with tuberculosis (TB) every
year, usually infecting the lungs, but also other organs of the body,
and can cause meningitis. Infection in children is relatively common,
and so establishing effective drug regimens that are easy to take and
monitor is important.
TB drug regimens are standardised globally, and include a combination of
drugs given daily for six months. More than 95% of children are cured
with this treatment. Giving anti-TB drugs twice- or thrice-weekly is
more convenient to supervise than daily treatment but may not be as
effective as daily treatment in curing children of TB. The World Health
Organization currently recommends only daily treatments, but some
national governments recommend twice- or thrice-weekly doses for
children with TB.
In this Cochrane review, the review authors compared children given
intermittent anti-TB treatment to those given daily treatment. They
examined the evidence up to 30 May 2013 and included four randomized
trials that compared twice-weekly treatment with daily doses of anti-TB
drugs, but none evaluated thrice-weekly dosing. The four trials included
563 children aged five months to 15 years, not known to be resistant to
TB drugs. The trials were published over 12 years ago and the regimens
used are not those currently recommended.
The trials were small, and did not detect a difference between
twice-weekly or daily treatment in the number of children who were
cured, died, relapsed, reported taking most or all of the drugs, or had
adverse effects. Whether regimens of drugs two or three times a week are
as good as regimens with daily doses remains unclear, as the evidence
base to date is small, and the regimens tested are not the same as
currently currently recommended drug combinations.
This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine
Bose, A.; Kalita, S.; Rose, W.; Tharyan, P. Intermittent versus daily therapy for treating tuberculosis in children. Cochrane Database of Systematic Reviews (2014) (Issue 1) Art. No.: CD007953. [DOI: 10.1002/14651858.CD007953.pub2]
Intermittent versus daily therapy for treating tuberculosis in children