Efficacy and safety of chemotherapy regimens containing fluoroquinolones in pediatric TB

Relevance Chemotherapy regimens for the treatment of multi- or extensively drug resistant TB (MDR/XDR TB) include fluoroquinolones, which have age restrictions on the use. To decide on the safety of fluoroquinolones in pediatric TB, it is important to assess benefits versus risks of adverse events. <b>Aim:</b> To study efficacy and safety of fluoroquinolones in the treatment for MDR/XDR TB in children. <b>Materials and methods:</b> We carried out a cohort prospective study in 2014-2019, which enrolled 89 patients 3-12 years old with different forms of sputum negative TB with prior exposure to MDR/XDR TB. Chemotherapy efficacy was assessed by clinical, laboratory, and radiological criteria. The monitoring of chemotherapy tolerance included physical examination, complete blood counts (CBC), assessment of biochemical parameters of liver and kidney functions, ECG. <b>Results:</b> The duration of chemotherapy was 9-12 months. The medical commission approved the administration of fluoroquinolones to 32 patients (36%). We obtained informed consents from the patients’ legal representatives. In all 32 cases treatment outcomes were defined as “effective chemotherapy course”, which was later confirmed by remote observations: lack of relapse 1-3 years after treatment completion. Intractable toxic reactions were observed in 10 out of 89 patients (11%); reactions to fluoroquinolones were observed in two out of 32 patients (6%) in the form of tendovaginitis (one patient) or the prolonged QT interval (one patient). <b>Conclusion:</b> We proved efficacy and safety of fluoroquinolones in the treatment of pediatric TB.