title: Twice weekly isoniazid and rifampin treatment of latent tuberculosis infection in Canadian plains Aborigines.
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.
authors.affiliation: Division of Tuberculosis Control, Department of Medicine, Research Center for the Elimination of Tuberculosis, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: B D
authors.initials: BD
authors.lastname: McNab
authors.forename: D D
authors.initials: DD
authors.lastname: Marciniuk
authors.forename: R A
authors.initials: RA
authors.lastname: Alvi
authors.forename: L
authors.initials: L
authors.lastname: Tan
authors.forename: V H
authors.initials: VH
authors.lastname: Hoeppner
mesh_terms: D000293:Adolescent; D000328:Adult; D044467:American Indian or Alaska Native; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007538:Isoniazid / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D012293:Rifampin / Q000008:administration & dosage* / Q000009:adverse effects; D012525:Saskatchewan; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin