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

Am J Respir Crit Care Med. 2000 Sep;162(3 Pt 1):989-93. doi: 10.1164/ajrccm.162.3.9804117.

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.

MeSH terms

  • Adolescent
  • Adult
  • American Native Continental Ancestry Group*
  • Antitubercular Agents / administration & dosage*
  • Antitubercular Agents / adverse effects
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Isoniazid / administration & dosage*
  • Isoniazid / adverse effects
  • Male
  • Rifampin / administration & dosage*
  • Rifampin / adverse effects
  • Saskatchewan
  • Tuberculosis, Pulmonary / drug therapy*

Substances

  • Antitubercular Agents
  • Isoniazid
  • Rifampin