The cure rate of tuberculosis has improved with shorter, well monitored courses of anti-TB drugs. This method is better than previous longer courses where compliance was poor and many patients did not take their medication regularly or stopped treatment too soon. Short course treatment is more cost effective with better patient compliance. However it must be well managed.
With short course treatment from a clinic, the anti-TB drugs are usually given on 5 days of the week only (Monday to Friday). Most children can be treated with combination tablets (rifampicin, INH and pyrazinamide or rifampicin and INH alone). Usually all 3 drugs are given for 2 months (the initial phase) and then only rifampicin and isoniazid are taken for a further 4 months (continuation phase). See Table 8.1 for the usual 6 month treatment regimen.
Children older than 8 years or children weighing more than 35 kg are treated with 4 drugs (ethambutol added) in the initial phase as with the adult anti-TB treatment regimen.
Corticosteroids are indicated in addition to anti-TB treatment in children with severe bronchial compression by enlarged lymph nodes and in tuberculous meningitis.
Tuberculosis is usually treated with rifampicin, INH and pyrazinamide for 2 months followed by rifampicin and INH only for another 4 months.