Children and adolescents requiring retreatment for TB

Box 5.13 WHO recommendation on retreatment regimens

Children and adolescents eligible for retreatment due to recurrence of TB symptoms secondary to relapse or reinfection or treatment interruption resulting in the need to restart treatment should be referred for a rapid molecular test to determine at least rifampicin resistance, and preferably also isoniazid resistance status, especially if this is within 6–12 months of treatment completion.

Based on the drug susceptibility profile, a treatment regimen can be repeated if no resistance is documented. If rifampicin resistance is present, an MDR/RR-TB regimen should be prescribed according to WHO recommendations.

In children and adolescents who have had treatment interruption, the reason for the interruption should be addressed, such as medicine stockouts, adverse effects from medicines, or need for additional patient or provider education.

Children and adolescents with previous treatment for unconfirmed TB should not be retreated for unconfirmed TB without referral to a centre with expertise in child TB management and paediatric care.

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