Evidence-based guidance on how to manage children and adolescents infected with or having active multidrug-resistant tuberculosis (MDR-TB) is needed. The aim of this publicationis to guide Member States in the WHO European Region to adequately address child and adolescent MDR-TB at the highest quality. All measures should be integrated into the Member States’ respective national TB programmes and other health services managing children with MDR-TB or at risk thereof to meet the End TB Strategy goals, as well as the related objectives laid out in the Tuberculosis Action Plan for the WHO European Region 2016–2020. This publicationis intended to update readers on recent scientific evidence as well as region-specific clinical and public health recommendations on child and adolescent MDR-TB. An overview ofthe epidemiology in the Region as well as specific aspects of managing paediatric MDR-TB is provided. Resources for national TB programme managers or clinicians are described to encourage them to seek expert advice for difficult-to-treat cases.

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