Pediatric HRZE

Isoniazid + Rifampin + Pyrazinamide + Ethambutol

Background:

A critical challenge to treating pediatric TB is the lack of appropriate medicines for children.  In 2010, WHO revised its recommended dosing for childhood TB medicines, but no formulations—either in fixed dose combinations (FDCs) or individual therapies—exist with the new dose recommendations. As a result, treatment is either delivered at levels lower than the recommended dosage using currently available formulations, or arrived at by breaking and crushing existing pediatric and adult formulations. This approach institutionalizes poor outcomes and the development of drug resistance. Additionally, the dosing of TB medicines for newborns and infants weighing 5 kg or less have not been adequately studied either as single drug entities or in combination (including as FDCs).

TB Alliance is working to develop child-appropriate formulations of the current standard TB treatment (Isoniazid + Rifampin + Pyrazinamide + Ethambutol) in line with the WHO's recommendations. Such a development would significantly impove the treatment and management of pediatric TB patients. In addition, the learnings from this project will inform the development of child-appropriate formulations of new TB treatments currently in the development pipeline, thereby reducing the delay between the availability of new TB treatments for adults and children.