Friday, June 5, 2015

Isoniazid-resistant Tuberculosis: A Problem More Common than You Might Have Thought


By: Lewis First, MD, MS; Editor-in-Chief

          Tuberculosis (TB) in children remains a global health problem and yet for decades we have relied on the use of isoniazid to help treat this devastating illness.  Sadly however, we have become more and more aware of isoniazid resistance in cases of TB in children.  But how prevalent is this resistance?  Yuen et al. (doi: 10.1542/peds.2015-0172) studied this question and estimated on the basis of their data that globally more than 120,000 children or 12.1% of all children with TB have isoniazid-resistant TB. Just where these cases are is well described in this study so please take a few minutes and read and learn more. 
      It appears, based on what the authors share in this study, that adults with resistance to isoniazid are transferring this resistance to children and raises new concerns as to whether we should continue to use this drug as first line in children with active or even latent disease.   
     The good news is that the AAP’s Committee on Infectious Diseases is also following this story and will keep us well informed of changes in treatment regimens as data like that shared in this important study continue to accumulate.  

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