Please see Chapter 8: Drug-resistant Tuberculosis. Children and adolescents at risk for drug-resistant TB include: (1) those with a history of treatment for TB disease; (2) contacts of cases with infectious drug-resistant TB disease; (3) those born in, or who have resided in, countries with a high prevalence of drug-resistant TB; and (4) patients infected by a source case who has a positive AFB smear or culture after 2 months of appropriate therapy or is not responding to a standard treatment regimen (details of microbiologic isolation, speciation and drug-resistance testing are provided in Chapter 3: Diagnosis of Tuberculosis Disease and Drug-resistant Tuberculosis).23 If a drug-resistant organism is isolated, obtain expert opinion from a physician experienced in the management of drug-resistant TB. There are also recent resources that discuss management of drug-resistant TB disease in children.68–70
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