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Int J Tuberc Lung Dis ; 22(11): 1344-1349, 2018 11 01.
Article in English | MEDLINE | ID: mdl-30355415

ABSTRACT

SETTING: Four New York City (NYC) Health Department tuberculosis (TB) clinics. OBJECTIVE: To assess the effectiveness of preferentially offering two shorter treatment regimens-4 months of daily rifampin (4R) and 3 months of once-weekly isoniazid and rifapentine (3HP)-as an alternative to 9 months of daily isoniazid (9H) for the treatment of latent tuberculous infection (LTBI). DESIGN: Retrospective analysis of patients treated for LTBI from January to June 2015. Poisson regression with robust standard error was used to examine the factors associated with treatment completion. RESULTS: Of the patients on 9H, 49% (27/55) completed treatment compared with 70% (187/269) of patients on 4R (P = 0.003) and 79% (99/125) of patients on 3HP (P < 0.001). When adjusting for age, sex, and TB risk factors, patients on 4R (adjusted risk ratio [aRR] 1.39, 95%CI 1.07-1.81) and 3HP (aRR 1.67, 95%CI 1.27-2.19) were more likely to complete treatment than patients on 9H. Treatment was discontinued due to side effects in 1% (3/269) of patients on 4R, 2% (2/125) of patients on 3HP, and 4% (2/55) of patients on 9H. CONCLUSIONS: Most patients were placed on shorter regimens for LTBI treatment, and higher treatment completion was observed. Encouraging community providers to use shorter regimens for LTBI treatment would reduce the TB disease burden in NYC.


Subject(s)
Drug-Related Side Effects and Adverse Reactions/epidemiology , Isoniazid/administration & dosage , Latent Tuberculosis/drug therapy , Latent Tuberculosis/epidemiology , Rifampin/analogs & derivatives , Adolescent , Adult , Aged , Aged, 80 and over , Antitubercular Agents/administration & dosage , Antitubercular Agents/adverse effects , Child , Child, Preschool , Directly Observed Therapy , Drug Administration Schedule , Drug Therapy, Combination , Female , Humans , Infant , Infant, Newborn , Isoniazid/adverse effects , Male , Medication Adherence , Middle Aged , New York City/epidemiology , Retrospective Studies , Rifampin/administration & dosage , Rifampin/adverse effects , Rifampin/therapeutic use , Risk Factors , Time Factors , Treatment Outcome , Young Adult
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