Shorter treatment for latent TB

Latent or primary tuberculosis (TB) is often diagnosed in vulnerable communities, and to completely eliminate the mycobacterium requires a long course of treatment. Conventionally this has been 9 months of isoniazid. Although this is highly effective if completed, not surprisingly adherence to treatment is generally poor, particularly as side-effects can be a problem, and the patient probably wasn’t feeling unwell in the first place. Rifampicin is effective afteronly 4 months' treatment, and might be more useful in practice. Until now, there had been no direct comparison of the two regimes.

A Canadian-based group conducted a non-inferiority unblinded trial, recruiting over 840 children up to age 17 years from Canada, Australia, Brazil, Indonesia and 3 African countries (Diallo T et al. NEJM 2018. doi:10.1056/NEJMoa1714284). They were randomised to receive either isoniazid 10–15 mg/kg/day for 9 months or rifampicin (here called rifampin) 10–20 mg/kg/day for 4 months. Adherence was assessed by pill...

from Archives of Disease in Childhood current issue https://ift.tt/2RYvx5x