Daily treatment regimen
Compared with adults, higher mg/kg doses of some tuberculosis drugs are needed in children to achieve effective serum concentrations.
For the daily regimen, use:
isoniazid (adults and children) 10 mg/kg up to 300 mg orally, daily for 6 months1. For dosage adjustment in adults with kidney impairment, see isoniazid dosage adjustment tuberculosis, daily regimen isoniazid
PLUS
rifampicin 10 mg/kg up to 600 mg (child younger than 14 years and more than 50 kg: 600 mg; child younger than 14 years and less than 50 kg: 15 mg/kg up to 450 mg) orally, daily for 6 months. For dosage adjustment in adults with kidney impairment, see rifampicin dosage adjustment tuberculosis, daily regimen rifampicin
PLUS
ethambutol 15 mg/kg up to 1200 mg (child younger than 14 years: 20 mg/kg up to 1200 mg) orally, daily for 2 months2. For dosage adjustment in adults with kidney impairment, see ethambutol (daily regimen) dosage adjustment tuberculosis, daily regimen ethambutol
PLUS
pyrazinamide 25 mg/kg up to 2 g (child younger than 14 years: 35 mg/kg up to 2 g) orally, daily for 2 months3 4. For dosage adjustment in adults with kidney impairment, see pyrazinamide dosage adjustment. tuberculosis, daily regimen pyrazinamide
The tables of practical doses for tuberculosis therapy for adults and children show daily doses that have been calculated based on weight, then rounded to a practical dose for the drug preparations available in Australia. Tuberculosis drug preparations available in Australia shows tuberculosis drug preparations available in Australia. Oral liquid formulations of isoniazid, ethambutol and pyrazinamide are not commercially available; for formulation options for children or people with swallowing difficulties, see the Don’t Rush to Crush Handbook, published by the Society of Hospital Pharmacists of Australia [URL].
Intravenous formulations of isoniazid5 and rifampicin are available and should be used in critically ill patients when oral therapy is not possible.
Pyridoxine is no longer recommended routinely for all patients taking isoniazid, but should be used in patients at risk of peripheral neuropathy (eg pregnant women, people with HIV infection, diabetes, malnutrition, chronic kidney disease, a history of hazardous alcohol use, or advanced age). Children on isoniazid therapy should receive pyridoxine if they are exclusively breastfed, have HIV infection or are malnourished. Children being breastfed by a mother who is taking isoniazid do not routinely require pyridoxine (see Tuberculosis in women who are pregnant or breastfeeding).