New thesis paves the way for improved treatment of children with tuberculosis

A century after the first vaccine was used against tuberculosis, the disease once again poses a global threat to public health. Every year 1.5 million people die as a result of resistant tuberculosis bacteria, and there are likely large hidden figures. According to estimations, only one in ten children that develop multidrug-resistant tuberculosis is diagnosed and treated. Now Yuanxi Zou, PhD student at the Department of Pharmacy, presents findings with potential to pave the way for effective development of new therapies even for the youngest patients.

“The challenges include limited clinical management and poor follow-up of children exposed to tuberculosis, and when they do meet a doctor, tuberculosis in a young body is difficult to diagnose. As a result, the pharmaceutical industry experience little incentive to develop formulations specifically for children, making proper treatment more difficult. In my PhD thesis, I show how pharmacometrics tools can relatively quickly help researchers determine whether and how drugs for adults can be adapted for children and young people,” says Yuanxi Zou.

In one study, Yuanxi Zou managed to deliver the antibiotic Delamanid in powdered form with positive outcome, prompting the World Health Organization, WHO, to update its recommendations for treatment. Yuanxi has also mapped how young bodies absorb and metabolize the relatively child-friendly drugs Pretomanid, Moxifloxacin and Clofazimine, all of which are part of the healthcare toolbox in the treatment of tuberculosis.

“Our results indicate that all four drugs can be formulated for safe and effective treatment of children with tuberculosis, but further research is required before we can confirm this with absolute certainty. Therefore, we are currently conducting a pharmacokinetic study of how Pretomanid affects children, a work in which we are applying a new method for the design and evaluation of clinical studies that we hope will further shorten the path to translate treatments for adults to also include children.”

Early data from this study are expected to arrive and form the basis for an interim analysis already in June. Before the end of 2025, Yuanxi Zou and her colleagues hope to both present their early results of pretomanid use in children and to translate experiences of the new study design method from this study in order to broaden its areas of possible application.

“Following my pharmacy degree at Shenzhen University, I enrolled Uppsala University's Master's Program in Drug Modeling before joining the research group in Pharmacometrics in 2019. My time in this environment has been continuously rewarding, and after my dissertation I will continue my work with a focus on our ongoing study, which feels incredibly inspiring. In early 2026, I will swap Sweden for Germany to continue my path in pharmacometrics, and when the time comes, I will bring with me so many valuable experiences, not to mention a fantastic network.”

text: Magnus Alsne, photo: Magnus Alsne a o