КОРОТКИЕ КУРСЫ ХИМИОТЕРАПИИ ТУБЕРКУЛЕЗА ОРГАНОВ ДЫХАНИЯ НА ОСНОВЕ ФТОРХИНОЛОНОВ У ДЕТЕЙ ИЗ ОЧАГОВ С МНОЖЕСТВЕННОЙ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТЬЮ ВОЗБУДИТЕЛЯ У ИСТОЧНИКА ИНФЕКЦИИ: ВОЗМОЖНОСТИ ИСПОЛЬЗОВАНИЯ

Abstract

Objective: to justify the potentials for use of fluoroquinolone-based short-course chemotherapy for the treatment of pulmonary TB in children from nidi of multi-drug resistant TB. Materials and methods. We carried out a cohort prospective study of 18 patients aged 2–5 years with newly diagnosed pulmonary TB with history of exposure to multidrug resistant TB in 2018–2020. The criteria for inclusion were as follows: local or small TB processes without bacterioexcretion, potential to form the initial combination containing at least four TB drugs including fluoroquinolones, use of TB drugs consideringpreserved drug susceptibility in the infection source. The criteria for exclusion: presence of diseases requiring long-term immunosuppressive therapy, administration of bedaquiline at any point of treatment. We used individualized chemotherapy regimens: 4 drugs in the intensive phase and 3 drugs in the continuation phase. The treatment course was 9–12 months. Results. All the patients completed treatment with effective outcomes, no relapse was detected one year later. Intoxication symptoms were removed after 3 months, positive X-ray dynamics was observed after 3 and 6 months in 66.7% of patients. Conclusion. We proved the effectiveness of fluoroquinolone-based short-course chemotherapy regimens in children with local or small forms of TB and history of exposure to multidrug resistant TB. The criteria for the total treatment duration (9 or 12 months) were the duration of the intensive phase and the duration of fluoroquinolone administration. If the intensive phase of treatment was less than 3 months or the administration of fluoroquinolones was less than 6 months, the total treatment duration was prolonged to 12 months.