A committee recommended three rifamycin-based regimens and two alternate six- or nine-month isoniazid monotherapy regimens for latent tuberculosis infection treatment. They gave priority to shorter-course regimens with similar efficacy, higher rates of completion, and favorable tolerability compared with the former standard nine-month regimen of isoniazid.
Dropping annual TB screening means emphasis on education, treatment
August 4, 2020
The Centers for Disease Control and Prevention dropped annual tuberculosis screening recommendations for healthcare workers last year, saying the disease continues to decline nationwide and healthcare workers appear to be at no greater risk than the general public. However, there are workers who could be exposed at work or in the community, including those from countries with endemic tuberculosis who can be offered new treatments for latent infection.
In an open-label trial, adults with latent tuberculosis infection were randomized to either four months of treatment with rifampin or nine months of treatment with isoniazid. The four-month rifampin regimen was non-inferior to nine months of isoniazid for prevention of active tuberculosis. It also was associated with a higher treatment completion rate and superior safety.
While the incidence of tuberculosis in the United States in 2017 was the lowest ever recorded, the current rate of decline would be required to almost double to reach the goal of elimination of the disease in this country by the year 2100.
A randomized clinical trial conducted in the United States and three other countries compared self-administered isoniazid and rifapentine with and without weekly reminders to directly observed therapy (DOT). Self-administered therapy without reminders was non-inferior to DOT in the United States; no other comparisons met non-inferiority criteria.