title: Isoniazid vs. rifampin for latent tuberculosis infection in jail inmates: toxicity and adherence.
abstract: This open-label randomized trial compared isoniazid (9 months) to rifampin (4 months) on toxicity and completion in a jailed population with latent tuberculosis infection. Rifampin resulted in fewer elevated liver function tests (risk ratio [RR] 0.39, 95% confidence interval [CI] [0.18, 0.86]) and less toxicity requiring medication withdrawal (RR 0.51, 95% CI [0.13, 2.01]), although one participant receiving rifampin experienced an allergic reaction. Completion was achieved for 33% receiving rifampin compared to 26% receiving isoniazid (p = .10). With careful monitoring rifampin is a safe and less toxic regimen and appears to be a reasonable alternative because of its shorter duration, allowing more people to complete treatment behind bars. Therapy completion in released inmates is unacceptably low and ensuring follow-up after discharge must be part of a decision to treat.
authors.affiliation: Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA 94143, USA. mary.white@nursing.ucsf.edu
authors.forename: Mary C
authors.initials: MC
authors.lastname: White
authors.forename: Jacqueline P
authors.initials: JP
authors.lastname: Tulsky
authors.forename: Ju Ruey-Jiuan
authors.initials: JR
authors.lastname: Lee
authors.forename: Lisa
authors.initials: L
authors.lastname: Chen
authors.forename: Joe
authors.initials: J
authors.lastname: Goldenson
authors.forename: Joanne
authors.initials: J
authors.lastname: Spetz
authors.forename: L Masae
authors.initials: LM
authors.lastname: Kawamura
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D023801:Directly Observed Therapy; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D055985:Latent Tuberculosis / Q000188:drug therapy*; D008111:Liver Function Tests; D008297:Male; D055118:Medication Adherence; D011330:Prisons; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012959:Socioeconomic Factors
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin