Adverse effects of anti-tuberculosis chemotherapy in children and adolescents: clinical challenges and management strategies

Tuberculosis remains a major global health problem, particularly among children and adolescents, who represent a vulnerable population with unique physiological and immunological characteristics. Anti-tuberculosis chemotherapy is highly effective in controlling the disease; however, it is frequently associated with a wide range of adverse drug reactions that may negatively affect treatment adherence, therapeutic outcomes, and quality of life. Children and adolescents are especially susceptible to undesirable effects due to age-related differences in drug metabolism, organ immaturity, and long-term exposure risks. This article aims to analyze the spectrum, frequency, and clinical significance of adverse events associated with anti-tuberculosis chemotherapy in pediatric and adolescent patients. Special attention is given to hepatotoxicity, gastrointestinal disturbances, allergic reactions, neurotoxicity, and hematological complications. The paper also discusses risk factors contributing to the development of adverse effects, including treatment duration, drug combinations, nutritional status, and comorbid conditions. Furthermore, strategies for early detection, monitoring, prevention, and management of chemotherapy-related complications are reviewed.