When are anti-tuberculous drugs given prophylactically to young children?

The following children should be given prophylactic (preventative) treatment:

  • Clinically well, asymptomatic children under 5 years of age who have been in the same home as someone who has smear-positive pulmonary TB. These young children are at very high risk of developing TB themselves as they have an immature immune system.
  • Children under 5 years who have a positive Mantoux skin test (10 mm or more), who are clinically well and have not recently been treated for TB.
  • HIV positive children who are in contact with adults with smear-positive tuberculosis.

Currently, prophylaxis consists of INH for 6 months. The treatment is given daily for 5 days a week using the same dose as for short course treatment. Children of 5 and older, who have been in close contact with an adult with untreated pulmonary TB, or have a positive Mantoux, are not given prophylaxis, as they are at far less risk of developing tuberculosis. However, they should be followed and treated if they develop any early signs of TB.

Prophylactic treatment is given to well children under 5 years of age who have been in close contact with someone with untreated tuberculosis.

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