Abstract:
Congenital pre-extensively drug-resistant tuberculosis is rare, and administration of second-line anti-tuberculosis medications to neonates is challenging due to the small doses required and limited availability of suitable formulations. Paediatric formulations have increasingly become available but may not be readily accessible in all countries. For the extremely preterm and low birth weight neonate, doses equivalent to a fraction of a tablet or capsule are required, with frequent dose adjustment for increasing age and weight during the course of treatment. The pharmaceutical formulation must be suitable for administration via enteral feeding tube and must be free of unsafe excipients. We report on the challenges, considerations and outcome of an extremely premature neonate with congenital pre-extensively drug-resistant tuberculosis who was successfully treated with second-line anti-tuberculosis medications. Child-friendly formulations were procured where available, and extemporaneous compounding of clofazimine, moxifloxacin and prothionamide oral suspensions was undertaken to enable administration of these medications.
摘要:
先天性广泛耐药结核病很少见,由于所需的小剂量和合适制剂的有限可用性,对新生儿的二线抗结核药物的给药具有挑战性。儿科制剂越来越多地变得可用,但可能并非在所有国家都容易获得。对于极度早产和低出生体重的新生儿,需要相当于片剂或胶囊的一小部分的剂量,在治疗过程中频繁调整剂量以增加年龄和体重。药物制剂必须适合于通过肠内饲管给药,并且必须不含不安全的赋形剂。我们报告挑战,患有先天性广泛耐药结核病的极早产新生儿的考虑因素和结局,该新生儿成功使用二线抗结核药物治疗。在可能的情况下采购了对儿童友好的配方,和氯法齐明的临时复合,采用莫西沙星和原硫脲口服混悬剂,使这些药物能够给药.