Περίληψη:
Background. A 9-month course of isoniazid monotherapy is currently
recommended for the treatment of latent tuberculosis infection (LTBI)
and has been shown to be effective in both children and adults. Reduced
compliance with this regimen has forced physicians to explore shorter
regimens. The aim of this study was to compare 3- and 4-month
combination regimens of isoniazid plus rifampin with a 9-month regimen
of isoniazid monotherapy for the treatment of LTBI in children.
Methods. This prospective, randomized, controlled study was conducted
over an 11-year period (1995-2005). In period 1 (1995-1998), 232
patients received isoniazid therapy for 9 months ( group A), and 238
patients received isoniazid and rifampin for 4 months (group B). In
period 2 (1999-2002), 236 patients were treated with isoniazid and
rifampin for 4 months (group C), and 220 patients received the same
regimen for 3 months (group D). All patients were observed for >= 3
years.
Results. Overall compliance with treatment was good, but patients who
received isoniazid monotherapy were less compliant than were those who
received short-course combination therapy (, for group A vs. group Pp.
011 B; for group C vs. group D). No patient in any group developed
clinical disease during the follow-up Pp. 510 period. New radiographic
findings suggestive of possible active disease were more common in
patients who received isoniazid monotherapy (24%) than in those treated
with shorter regimens (11.8%, 13.6%, and 11% for groups B, C, and D,
respectively; for group A vs. group B; for group C vs. group D). Serious
drug-related adverse effects were not detected.
Conclusions. Short-course treatment with isoniazid and rifampin for 3- 4
months is safe and seems to be superior to a 9-month course of isoniazid
monotherapy.
Συγγραφείς:
Spyridis, Nikos P.
Spyridis, Panayotis G.
Gelesme, Anna and
Sypsa, Vana
Valianatou, Mina
Metsou, Flora
Gourgiotis,
Dimitris
Tsolia, Maria N.