Treatment completion and costs of a randomized trial of rifampin for 4 months versus isoniazid for 9 months.
There is little published information regarding treatment completion, safety, and efficacy of rifampin administered daily for 4 months-a recommended alternative to 9 months of isoniazid for therapy of latent tuberculosis infection. In an open-label randomized trial at a university-affiliated respiratory hospital, consenting patients whose treating physician had recommended therapy for latent tuberculosis infection were randomized to daily self-administered rifampin for 4 months or daily self-administered isoniazid for 9 months. Of 58 patients randomized to rifampin, 53 (91%) took 80% of doses, and 50 (86%) took more than 90% of doses within 20 weeks compared with 44 (76%) and 36 (62%) who took 80 and 90%, respectively, of doses of isoniazid within 43 weeks (relative risks: 80% of doses, 1.2 [95% confidence interval: 1.02, 1.4]; 90% of doses, 1.4 [1.1, 1.7]). Adverse events resulted in permanent discontinuation of therapy for two (3%) patients taking rifampin, and for eight (14%) patients taking isoniazid. Three patients developed drug-induced hepatitis--all were taking isoniazid. Total costs of therapy were significantly higher for isoniazid. In conclusion, completion of therapy was significantly better with 4 months of rifampin and major side effects were somewhat lower. Further studies are needed to assess the safety and efficacy of the 4-month rifampin regimen.
Menzies
Dick
D
Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, 3650 St-Urbain, Room K1.24, Montreal, PQ, H2X 2P4 Canada. dick.menzies@mcgill.ca
Dion
Marie-Josée
MJ
Rabinovitch
Barry
B
Mannix
Sharyn
S
Brassard
Paul
P
Schwartzman
Kevin
K
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000191:economics*; D003365:Costs and Cost Analysis; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage* / Q000191:economics; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010349:Patient Compliance; D012293:Rifampin / Q000008:administration & dosage* / Q000191:economics; D014376:Tuberculosis / Q000188:drug therapy*
D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin