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Short-course isoniazid plus rifampin effective for latent TB in children
A three- or four-month regimen of isoniazid plus rifampin is at least as effective as a nine-month course of isoniazid monotherapy in treating latent TB in children, according to results of a prospective, randomized trial.
As noted in the report in the September 15th issue of Clinical Infectious Diseases, dual therapy may be preferable because the shorter duration of treatment was associated with better compliance.
"Tuberculosis remains a major public health problem, and infectious diseases specialists should continue to explore new ideas on the line of prevention, diagnosis and management of infected patients," senior author Dr. Maria N. Tsolia told Reuters Health. "We feel that this study is assisting in this direction, especially because it involved a pediatric population and the results were not extracted from adult studies."
The American Academy of Pediatrics recommends nine months of isoniazid chemoprophylaxis for children and adolescents with latent TB, the authors point out. The British Thoracic Society recommends three months treatment with isoniazid plus rifampin.
Dr. Tsolia and her associates at the TB clinic of Athens University School of Medicine evaluated the different regimens in children ages 12 months to 14 years who were asymptomatic and had positive tuberculin skin test results. Chest x-rays were normal or indicative of inactive lesions.
Over an 11-year period, patients in groups of 220 to 238 were randomly assigned to different treatment protocols:
- Isoniazid monotherapy, 10 mg/kg daily (maximum dose 300 mg) for nine months versus isoniazid plus rifampin 10 mg/kg daily (maximum 600 mg) for four months (conducted between 1995-1998).
- Isoniazid plus rifampin for four months versus three months (1999-2002).