Drug dosing for the treatment of tuberculosis in children

Drugs	Dosage forms	Daily dosage (range; mg/kg)	Twice a week dosage (mg/kg per dose)	Maximum dose	Most common adverse reactions
Ethambutol	Tablets: 100 mg 400 mg	20 (15 to 25)	50	Daily: 1 g Twice a week: 2.5 g	Optic neuritis (usually reversible), decreased red-green color discrimination, gastrointestinal tract disturbances, hypersensitivity
Isoniazid*	Scored tablets: 100 mg	10 (10 to 15)	20 to 30	Daily: 300 mg	Mild hepatic enzyme elevation, hepatitis, peripheral neuritis, hypersensitivity
Isoniazid*	300 mg	10 (10 to 15)	20 to 30	Twice a week: 900 mg
Pyrazinamide*	Scored tablets: 500 mg	35 (30 to 40)	50	2 g	Hepatotoxic effects, hyperuricemia, arthralgia, gastrointestinal tract upset, pruritus, rash
Rifampin*	Capsules: 150 mg 300 mg Syrup formulated capsules	15 to 20^¶	15 to 20^¶	600 mg	Orange discoloration of secretions or urine, staining of contact lenses, vomiting, hepatitis, influenza-like reaction, thrombocytopenia, pruritus; oral contraceptives may be ineffective

* Rifamate is a capsule containing 150 mg of isoniazid and 300 mg of rifampin. Two capsules provide the usual adult (greater than 50 kg) daily doses of each drug. Rifater, in the United States, is a capsule containing 50 mg of isoniazid, 120 mg of rifampin, and 300 mg of pyrazinamide. Isoniazid and rifampin also are available for parenteral administration.
¶ Many experts recommend using a daily rifampin dose of 20 to 30 mg/kg/day for infants and toddlers and for serious forms of tuberculosis such as meningitis and disseminated disease.

Reproduced with permission of the American Academy of Pediatrics, from: Tuberculosis. In: Red Book: 2021 Report of the Committee on Infectious Diseases, 32nd ed, Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH (Eds), Copyright © 2021; permission conveyed through Copyright Clearance Center, Inc.

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