Treatment completion and costs of a randomized trial of rifampin for 4 months versus isoniazid for 9 months.

Abstract

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.

• Authors: Dick Menzies, Marie-Josée Dion, Barry Rabinovitch, Sharyn Mannix, Paul Brassard, Kevin Schwartzman
• Journal: American journal of respiratory and critical care medicine (Am J Respir Crit Care Med) Vol. 170 Issue 4 Pg. 445-9 (Aug 15 2004) ISSN: 1073-449X [Print] United States
• PMID: 15172892 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antitubercular Agents
• Isoniazid
• Rifampin

Topics

• Adult
• Antitubercular Agents (administration & dosage, economics)
• Costs and Cost Analysis
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Humans
• Isoniazid (administration & dosage, economics)
• Male
• Outcome and Process Assessment, Health Care
• Patient Compliance
• Rifampin (administration & dosage, economics)
• Tuberculosis (drug therapy)