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Enhancement of treatment completion for latent tuberculosis infection with 4 months of rifampin.
Chest. 2006 Dec; 130(6):1712-7.Chest

Abstract

BACKGROUND

Isoniazid is the standard medication used to treat latent tuberculosis infection (LTBI). The lengthy treatment with isoniazid, its perceived hepatotoxicity, and the increasing influx of foreign-born persons from countries with a higher prevalence of isoniazid resistance have compromised this regimen. In 2000, the Centers for Disease Control and Prevention guidelines recommended 4 months of rifampin (4R) as an acceptable alternative regimen to 9 months of isoniazid (9H). In a county chest clinic in northern New Jersey, a self-administered 9H regimen for patients with LTBI was generally prescribed until the year 2002. After recognizing poor completion rates, LTBI treatment was shifted predominantly to the alternative 4R regimen.

METHODS

Medical records of patients placed on LTBI treatment during 2000 (predominantly a 9H regimen) and 2003 (predominantly a 4R regimen) were reviewed. A total of 474 patients were included in the study. chi(2), Fishers exact, two-sample t, and Wilcoxon rank-sum tests and logistic regression were used to analyze the data. The main outcome variable was treatment completion.

RESULTS

A total of 80.5% of patients receiving 4R and 53.1% receiving 9H completed treatment (p < 0.0001); 34.7% of patients receiving 9H were unavailable for follow-up, compared to 12.6% receiving 4R (p = <0.0001). Fewer drug reactions were observed in the group receiving 4R compared to the group receiving 9H (3.1% vs 5.8%), although this was not statistically significant. Logistic regression analysis identified treatment regimen as a significant predictor for treatment completion (odds ratio [OR], 5.1; 95% confidence interval [CI], 3.3 to 8.1). Employment was negatively associated with treatment completion in the same model (OR, 0.54; 95% CI, 0.34 to 0.94).

CONCLUSIONS

Patients receiving 4R were significantly more likely to complete therapy than those receiving 9H.

Authors+Show Affiliations

Global Tuberculosis Institute, School of Public Health, New Jersey Medical School, 225 Warren St, Second Floor, Newark, NJ 07103, USA. lardizaa@umdnj.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

17166986

Citation

Lardizabal, Alfred, et al. "Enhancement of Treatment Completion for Latent Tuberculosis Infection With 4 Months of Rifampin." Chest, vol. 130, no. 6, 2006, pp. 1712-7.
Lardizabal A, Passannante M, Kojakali F, et al. Enhancement of treatment completion for latent tuberculosis infection with 4 months of rifampin. Chest. 2006;130(6):1712-7.
Lardizabal, A., Passannante, M., Kojakali, F., Hayden, C., & Reichman, L. B. (2006). Enhancement of treatment completion for latent tuberculosis infection with 4 months of rifampin. Chest, 130(6), 1712-7.
Lardizabal A, et al. Enhancement of Treatment Completion for Latent Tuberculosis Infection With 4 Months of Rifampin. Chest. 2006;130(6):1712-7. PubMed PMID: 17166986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enhancement of treatment completion for latent tuberculosis infection with 4 months of rifampin. AU - Lardizabal,Alfred, AU - Passannante,Marian, AU - Kojakali,Faysal, AU - Hayden,Christopher, AU - Reichman,Lee B, PY - 2006/12/15/pubmed PY - 2007/1/5/medline PY - 2006/12/15/entrez SP - 1712 EP - 7 JF - Chest JO - Chest VL - 130 IS - 6 N2 - BACKGROUND: Isoniazid is the standard medication used to treat latent tuberculosis infection (LTBI). The lengthy treatment with isoniazid, its perceived hepatotoxicity, and the increasing influx of foreign-born persons from countries with a higher prevalence of isoniazid resistance have compromised this regimen. In 2000, the Centers for Disease Control and Prevention guidelines recommended 4 months of rifampin (4R) as an acceptable alternative regimen to 9 months of isoniazid (9H). In a county chest clinic in northern New Jersey, a self-administered 9H regimen for patients with LTBI was generally prescribed until the year 2002. After recognizing poor completion rates, LTBI treatment was shifted predominantly to the alternative 4R regimen. METHODS: Medical records of patients placed on LTBI treatment during 2000 (predominantly a 9H regimen) and 2003 (predominantly a 4R regimen) were reviewed. A total of 474 patients were included in the study. chi(2), Fishers exact, two-sample t, and Wilcoxon rank-sum tests and logistic regression were used to analyze the data. The main outcome variable was treatment completion. RESULTS: A total of 80.5% of patients receiving 4R and 53.1% receiving 9H completed treatment (p < 0.0001); 34.7% of patients receiving 9H were unavailable for follow-up, compared to 12.6% receiving 4R (p = <0.0001). Fewer drug reactions were observed in the group receiving 4R compared to the group receiving 9H (3.1% vs 5.8%), although this was not statistically significant. Logistic regression analysis identified treatment regimen as a significant predictor for treatment completion (odds ratio [OR], 5.1; 95% confidence interval [CI], 3.3 to 8.1). Employment was negatively associated with treatment completion in the same model (OR, 0.54; 95% CI, 0.34 to 0.94). CONCLUSIONS: Patients receiving 4R were significantly more likely to complete therapy than those receiving 9H. SN - 0012-3692 UR - https://www.unboundmedicine.com/medline/citation/17166986/Enhancement_of_treatment_completion_for_latent_tuberculosis_infection_with_4_months_of_rifampin_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(15)50891-X DB - PRIME DP - Unbound Medicine ER -