Current strategies for the treatment of MDR-TB in children and adolescents

Introduction:The article addressed the challenge posed by drug-resistant tuberculosis, particularly in its multidrug-resistant form (MDR-TB). It explained how this variant of the disease required more extensive, toxic and costly treatments compared to susceptible tuberculosis, critically affecting vulnerable populations such as children and adolescents.Development:He explained that treatments for MDR-TB could be standardized or individualized, the latter being more effective but historically long and with multiple adverse effects. He explained that, until 2018, treatments required at least five second-line drugs for 24 months. He also described the standard two-phase treatment for tuberculosis (intensive and consolidation), and how the emergence of resistance to fluoroquinolones and aminoglycosides worsened the results.The article highlighted the impact of newer drugs, such as bedaquiline, delamanid, clofazimine, linezolid and pretomanid, which allowed for shorter, completely oral regimens with less toxicity. He clarified that, although bedaquiline showed great efficacy, its long half-life presented risks if treatment was abandoned or cross-resistance existed.ConclusionHe concluded that MDR-TB constituted a significant challenge for healthcare systems, especially in contexts such as Argentina, where access to medicines, pediatric formulations and adequate diagnostics was limited. Finally, he emphasized the importance of specific research in children and adolescents to improve quality of life, strengthen healthcare policies and move towards more equitable and effective care.