Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

LTBI Treatment Regimens
Table 4 RECOMMENDED DRUG REGIMENS FOR TREATMENT OF LATENT TUBERCULOSIS
INFECTION IN CHILDREN 20
Drug
Isoniazid
(INH)
Rifampin
(RIF)
Interval and
Duration
Daily for 9
months
Twice weekly
for 9 months
Daily for 6
months in
children
Comments
In HIV-infected patients, INH may be administered concurrently
with nucleoside reverse transcriptase inhibitors (NRTIs), protease
inhibitors, or non-nucleoside reverse transcriptase inhibitors
(NNRTIs).
Rating *
(evidence) †
HIV– HIV+
A (II) A (II)
DOT must be used with twice-weekly dosing. B (II) B (II)
RIF is ONLY used for children who are contacts of patients with
INH-resistant, RIF-susceptible TB or for persons who do not
tolerate isoniazid therapy.
In HIV-infected patients, Rifampin may interfere with some
antiretroviral drugs. Expert consultation is advised.
The optimal length of RIF therapy in children with LTBI is not
known; however, the American Academy of Pediatrics
recommends 6 months of treatment. 21
B (II) B (III)
Definitions of abbreviations: DOT = directly observed therapy; HIV = human immunodeficiency virus; LTBI = latent tuberculosis
infection;.
* Strength of recommendation: A = Preferred, B = Acceptable alternative, C = Offer when A and B cannot be given.
† Quality of evidence: I = Randomized clinical trial data, II = Data from clinical trials that are not randomized or were conducted in
other populations, III = Expert opinion
Source: Adapted from CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-
6):31.
Table 5: RECOMMENDATIONS AND CONSIDERATIONS FOR USING THE 12-WEEK
ISONIAZID-RIFAPENTINE REGIMEN 22
Consider the regimen for: Regimen is NOT recommended for: Comments:
Healthy persons 12 years or
older
Recently exposed contacts of
infectious TB and new TB
converters
Persons with radiographic
findings of healed pulmonary TB
HIV infected persons who are
not taking antiretroviral
medications
Children younger than 2 years of age
People with HIV/AIDS who are taking
antiretroviral treatment
People presumed to be infected with
INH or RIF-resistant M. tuberculosis
Pregnant women or women
expecting to become pregnant within
the 12–week treatment
Individuals who had prior adverse
events or hypersensitivity to rifampin
Therapy may be considered in
children ages 2-12 on a case by
case basis
Source: CDC. Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection.
MMWR 2011; 60(48); 1650-1653.
A L A S K A T U B E R C U L O S I S P R O G R A M M A N U A L Diagnosis and Treatment of LTBI and TB Disease in Children 9.14
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