Safety of rifampin and pyrazinamide for the treatment of latent tuberculosis infection.
A 2-month regimen of rifampin and pyrazinamide (2RZ) became an accepted alternative for treatment of latent tuberculosis (TB) after initial studies in HIV-seropositive patients demonstrated safety and efficacy. Once this alternative came into widespread use, however, a number of cases of severe and fatal hepatitis associated with 2RZ were reported. Although the initial experience with HIV-seropositive patients was encouraging, subsequent research demonstrated that the risk of 2RZ-associated hepatitis is considerably greater than the risk of hepatitis associated with isoniazid treatment for latent TB. Updated guidelines now recommend only restricted use of the 2RZ regimen for latent TB, with careful supervision.
Stout
Jason E
JE
Department of MEdicine, Duke University Medical Center, Durham, NC 27710, USA. stout002@mc.duke.edu
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular / Q000009:adverse effects / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects / Q000627:therapeutic use; D011718:Pyrazinamide / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012293:Rifampin / Q000009:adverse effects / Q000627:therapeutic use*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin