For MDR-TB, the risk of infection and disease is likely to be similar to that for other TB contacts. Most international TB guidelines and networks recommend a fluoroquinolone-based preventive treatment on a case-by-case basis. Three clinical trials are currently underway that are likely to inform updated TPT guidance when results become available (ISRCTN identifier ISRCTN92634082, ClinicalTrials.gov identifier NCT03568383 and ANZCTR identifier ACTRN12616000215426). Treatment of TB disease in children The treatment principles for TB in children are the same as those for adults. The goal is to cure the patient with minimal side-effects, prevent relapse, reduce disease transmission and avoid the development of drug resistance. Anti-TB treatment is typically divided into an intensive phase with three or more drugs followed by a continuation phase with two or more drugs (table 4) [27]. Weight-band dosing and child-friendly formulations are available for a) b) d) c) FIGURE 3 Examples of specific radiological manifestations of childhood TB. a) Uncomplicated lymph-node disease, b) adult-type disease with breakdown and cavities, c) miliary picture, and d) pleural effusion. Reproduced and modified from the Diagnostic CXR Atlas for Tuberculosis in Children Image Library (https:// atlaschild.theunion.org/) with permission. https://doi.org/10.1183/2312508X.10025322 219 CHILDREN AND ADOLESCENTS |E. LÓPEZ-VARELA ET AL.
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