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Am J Respir Crit Care Med. 2000 Sep;162(3 Pt 1):989-93.

Twice weekly isoniazid and rifampin treatment of latent tuberculosis infection in Canadian plains Aborigines.

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1
Division of Tuberculosis Control, Department of Medicine, Research Center for the Elimination of Tuberculosis, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Abstract

Six months of twice weekly directly observed isoniazid and rifam-picin treatment of latent tuberculosis (TB) infection was implemented to improve the outcome of treatment. A total of 591 infected aborigines without previous tuberculosis or treatment of latent TB infection received twice weekly isoniazid and rifampicin for 6 mo from 1992 to 1995. The outcome was compared with 403 infected aborigines without previous tuberculosis or treatment of latent TB infection who received self-administered isoniazid daily for 1 yr from 1986 to 1989. Of patients, 487 (82%) completed the twice weekly 6-mo regimen compared with 77 (19%) who completed the daily 12-mo regimen. The main reason for incomplete treatment was default. Both groups were followed over a 6-yr period. The rate of tuberculosis in the twice-weekly isoniazid and rifampicin-treated patients was 0.9/1,000 patient-years compared with 9/1,000 patient-years in the daily isoniazid-treated patients. The rate of side effects was higher for directly observed treatment patients, 136/1,000 patient-years of drugs, compared with 39/ 1,000 patient-years for self-administered treatment patients. Life-threatening side effects such as skin allergic reactions and hepatitis were the same in both groups. A regimen of 52 doses of directly observed twice weekly isoniazid and rifampicin is an effective and well-tolerated regimen to improve the outcome of the treatment of latent tuberculosis infection in a population with a high rate of default with daily self-administered isoniazid.

PMID:
10988118
DOI:
10.1164/ajrccm.162.3.9804117
[Indexed for MEDLINE]
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