Preventive chemotherapy in children exposed to multiple drug resistant tuberculosis

The objective of the study: to assess the safety and efficacy of preventive anti-tuberculosis treatment of children exposed to multiple drug resistant tuberculosis (MDR TB) using different combinations of anti-tuberculosis drugs.Subjects and methods. 150 children at the age from 1 to 17 years old inclusive were enrolled in the study, they all had a high risk of being infected with MDR M. tuberculosis. All children had been exposed to MDR TB and had no clinical or X-ray signs of active disease. The average age of children made 9.5 ± 4.1 (median 10) years old, girls and boys made 46.6% and 53.4% respectively. Children were divided into two groups of observation: the main one included 100 children who were prescribed with preventive anti-tuberculosis treatment, while the control group consisted of 50 children who did not receive any preventive treatment for various reasons. In the main group, children received various regimens of preventive chemotherapy: pyrazinamide and ethambutol (ZE) – 30 people; pyrazinamide and prothionamide (ZPt) – 40 patients; three drugs – pyrazinamide, ethambutol, and prothionamide (ZEPt) – 30 children. The combination of drugs was based on the drug resistance of the intended source of infection. Treatment was prescribed for 3-4 months.Results: the use of a combination of first line (pyrazinamide and ethambutol) and second line (prothionamide) drugs demonstrated lower toxicity of the regimen consisting of pyrazinamide and ethambutol compared to pyrazinamide and prothionamide regimen: OR = 0.3; 95% CI – 0.2-0.6.In Z + Pt and Z + E + Pt regimens, adverse events occurred in 22.5 and 20% of cases, respectively, and in Z + E regimen – only in 6.6% of cases (p < 0.05)