What is Isoniazid?
Isoniazid is an antibiotic commonly used to prevent and treat tuberculosis (TB). It is often prescribed in both adults and children for its effectiveness against Mycobacterium tuberculosis.
How is Isoniazid Administered in Pediatric Patients?
Isoniazid is typically administered orally in the form of a tablet, liquid, or chewable tablet. The dosage for children is generally calculated based on body weight, often at a rate of 10-15 mg/kg per day, with a maximum dose of 300 mg per day. It is crucial to follow the prescribed
dosage and duration to ensure effective treatment and prevention of antibiotic resistance.
What are the Side Effects of Isoniazid in Children?
While isoniazid is generally well-tolerated, it can cause side effects, particularly with long-term use. Common side effects include nausea, vomiting, and abdominal pain. More serious side effects may encompass liver toxicity, peripheral neuropathy, and allergic reactions. Pediatric patients should be monitored for symptoms of
hepatotoxicity, such as jaundice, dark urine, and fatigue.
How Can Side Effects be Minimized?
To minimize the risk of liver toxicity, it is important to conduct baseline liver function tests before starting treatment and to continue monitoring liver enzymes periodically. Administering
vitamin B6 (pyridoxine) alongside isoniazid can help prevent peripheral neuropathy, especially in malnourished children or those with a pre-existing risk of neuropathy.
What Precautions Should be Taken?
Before initiating isoniazid therapy, it is crucial to perform a thorough medical history and examination to identify any potential risk factors for adverse reactions. Children with pre-existing liver disease or those taking other hepatotoxic drugs may require alternative treatments. It is also important to educate caregivers on the importance of adherence to the prescribed regimen and to report any unusual symptoms promptly.
What are the Alternatives to Isoniazid?
In cases where isoniazid is not suitable, alternative medications like
rifampin or a combination of drugs (such as in the case of multi-drug resistant TB) may be considered. The choice of alternative therapy should be guided by susceptibility testing and the child's overall health status.
Conclusion
Isoniazid remains a cornerstone in the treatment and prevention of TB in pediatric populations. Despite its potential side effects, its benefits often outweigh the risks when used appropriately. Ongoing monitoring and adherence to prescribed guidelines are pivotal in ensuring the safety and effectiveness of isoniazid therapy in children.
