Published ahead of print on June 1, 2004, doi:10.1164/rccm.200404-478OC
Am. J. Respir. Crit. Care Med., Volume 170, Number 4, August 2004, 445-449
A more recent version of this article appeared on August 15, 2004
Submitted on April 8, 2004
Accepted on May 30, 2004
Treatment Completion and Costs (in a Randomized Trial) of 4 Months Rifampin vs 9 Months Isoniazid
Dick Menzies1*, Marie-Josee Dion1, Barry Rabinovitch1, Sharyn Mannix1, Paul Brassard2, and Kevin Schwartzman1
1 Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, Montreal, Quebec, Canada,
2 Division of Clinical Epidemiology, Royal Victoria Hospital, Montreal, Quebec, Canada
* To whom correspondence should be addressed. E-mail: dick.menzies{at}mcgill.ca.
There is little published information regarding treatment completion, safety and efficacy of four months daily Rifampin - a recommended alternative to nine months Isoniazid for therapy of latent tuberculosis infection. In an open label randomized trial, at a university affiliated respiratory hospital, consenting patients whose treating physician had recommended therapy for latent tuberculosis infection, were randomized to daily self-administered Rifampin for four months or daily self-administered Isoniazid for nine months. Of 58 patients randomized to Rifampin, 53 (91%) took 80% of doses, and 50 (86%) took more than 90% of doses within 20 weeks compared to 44(76%) and 36 (62%) who took 80% and 90% respectively of doses of Isoniazid within 43 weeks [relative risks: 80% of doses 1.2; (95% confidence interval: 1.02,1.4); 90% of doses: 1.4;(1.1,1.7)]. Adverse events resulted in permanent discontinuation of therapy in 2 (3%) patients taking Rifampin, and 8 (14%) patients taking Isoniazid. Three patients developed drug induced hepatitis - all taking Isoniazid. Total costs of therapy were significantly higher for Isoniazid. In conclusion, completion of therapy was significantly better with four months Rifampin and major side effects somewhat lower. Further studies are needed to assess the safety and efficacy of the four month Rifampin regimen.
Key words: Latent TB Infection, Treatment of Latent TB Infection, Tuberculosis Prevention
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