title: Rifampicin resistance after treatment for latent tuberculous infection: a systematic review and meta-analysis.
abstract: Treatment for latent tuberculous infection (LTBI) reduces the risk of tuberculosis (TB) disease. Shorter, rifamycin-containing regimens have been shown to be as effective as 6 months of isoniazid and superior with regard to safety and completion rate. It is unknown whether preventive therapy with rifamycins increases resistance to the drugs used.
  
  
  
  To determine whether treatment for LTBI with rifamycin-containing regimens leads to significant development of resistance against rifamycins.
  
  
  
  Systematic review and meta-analysis.
  
  
  
  We included six randomised-controlled trials of rifamycin-containing regimens for LTBI treatment that reported drug resistance. There was no statistically significant increased risk of rifamycin resistance after LTBI treatment with rifamycin-containing regimens compared to non-rifamycin-containing regimens (RR 3.45, 95%CI 0.72-16.56; P = 0.12) or placebo (RR 0.20, 95%CI 0.02-1.66; P = 0.13).
  
  
  
  Preventive treatment with rifamycin-containing regimens does not significantly increase rifamycin resistance. Programmatic management of LTBI requires the creation of sound surveillance systems to monitor drug resistance.
authors.affiliation: Independent consultant, Geneva, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: den Boon
authors.affiliation: The Global TB Programme, World Health Organization, Geneva, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Matteelli
authors.affiliation: The Global TB Programme, World Health Organization, Geneva, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Getahun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D012293:Rifampin / Q000009:adverse effects / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000904:Antibiotics, Antitubercular; D012293:Rifampin