PMID- 29363561
OWN - NLM
STAT- MEDLINE
DCOM- 20190116
LR  - 20190116
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 141
IP  - 2
DP  - 2018 Feb
TI  - Completion Rate and Safety of Tuberculosis Infection Treatment With Shorter 
      Regimens.
LID - e20172838 [pii]
LID - 10.1542/peds.2017-2838 [doi]
AB  - BACKGROUND: The traditional treatment of tuberculosis (TB) infection (9 months of 
      daily isoniazid [9H]) is safe but completion rates of <50% are reported. Shorter 
      regimens (3 months of once-weekly isoniazid and rifapentine [3HP] or 4 months of 
      daily rifampin [4R]) are associated with improved adherence in adults. METHODS: 
      This was a retrospective cohort study (2014-2017) of children (0-18 years old) 
      seen at a children's TB clinic in a low-incidence nation. We compared the 
      frequency of completion and adverse events (AEs) in children receiving 3HP, 4R, 
      and 9H; the latter 2 regimens could be administered by families (termed 
      self-administered therapy [SAT]) or as directly observed preventive therapy 
      (DOPT); 3HP was always administered under DOPT. RESULTS: TB infection treatment 
      was started in 667 children: 283 (42.4%) 3HP, 252 (37.8%) 9H, and 132 (19.8%) 4R. 
      Only 52% of children receiving 9H via SAT completed therapy. Children receiving 
      3HP were more likely to complete therapy than the 9H (SAT) group (odds ratio [OR] 
      27.4, 95% confidence interval [CI]: 11.8-63.7). Multivariate analyses found 
      receipt of medication under DOPT (OR: 5.72, 95% CI: 3.47-9.43), increasing age 
      (OR: 1.09, 95% CI: 1.02-1.17), and the absence of any AE (OR: 1.70, 95% CI: 
      0.26-0.60) to be associated with completing therapy. AEs were more common in the 
      9H group (OR: 2.51, 95% CI: 1.48-4.32). Two (0.9%) children receiving 9H 
      developed hepatotoxicity; no child receiving 3HP or 4R developed hepatotoxicity. 
      CONCLUSIONS: Shorter regimens are associated with increased completion rates and 
      fewer AEs than 9H.
CI  - Copyright (c) 2018 by the American Academy of Pediatrics.
FAU - Cruz, Andrea T
AU  - Cruz AT
AD  - Department of Pediatrics, Baylor College of Medicine, Houston, Texas 
      acruz@bcm.edu.
FAU - Starke, Jeffrey R
AU  - Starke JR
AD  - Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
RN  - 0 (Antitubercular Agents)
RN  - V83O1VOZ8L (Isoniazid)
RN  - VJT6J7R4TR (Rifampin)
RN  - XJM390A33U (rifapentine)
SB  - IM
MH  - Adolescent
MH  - Antitubercular Agents/*administration & dosage/adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Directly Observed Therapy
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Isoniazid/*administration & dosage/adverse effects
MH  - Male
MH  - Medication Adherence
MH  - Retrospective Studies
MH  - Rifampin/administration & dosage/adverse effects/*analogs & derivatives
MH  - Texas
MH  - Tuberculosis/*drug therapy
COIS- POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential 
      conflicts of interest to disclose.
EDAT- 2018/01/25 06:00
MHDA- 2019/01/17 06:00
CRDT- 2018/01/25 06:00
PHST- 2017/11/08 00:00 [accepted]
PHST- 2018/01/25 06:00 [pubmed]
PHST- 2019/01/17 06:00 [medline]
PHST- 2018/01/25 06:00 [entrez]
AID - peds.2017-2838 [pii]
AID - 10.1542/peds.2017-2838 [doi]
PST - ppublish
SO  - Pediatrics. 2018 Feb;141(2):e20172838. doi: 10.1542/peds.2017-2838.