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Abstract: Slide Presentations |

EXPERIENCE USING THREE REGIMENS TO TREAT LATENT TUBERCULOSIS INFECTION IN A TARGETED TESTING PROGRAM, 2000-2004 FREE TO VIEW

Lewis R. Mooney, MD*; Margaret J. Oxtoby, MD; John C. Grabau, PhD; Edwin M. Rodriguez
Author and Funding Information

Suffolk County, New York, Department of Health Services, Brentwood, NY


Chest


Chest. 2005;128(4_MeetingAbstracts):176S. doi:10.1378/chest.128.4_MeetingAbstracts.176S-b
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Abstract

PURPOSE:  Groups targeted for the Targeted Testing Program (TTP) were foreign-born persons recently arrived from high TB prevalence countries. These individuals were deemed unlikely to complete the Centers for Disease Control and Prevention (CDC) preferred nine-month regimen of isoniazid (9-INH) to treat Latent Tuberculosis Infection (LTBI) due to their seasonal jobs. Use of a shorter course regimen to treat LTBI was initiated to help improve completion of therapy rates in this population.

METHODS:  The TTP began using a four-month course of Rifampin 4-RIF to treat LTBI after reports of fatal and severe liver injuries associated with the use of a 2-month course rifampin and pyrazinamide (2-RZ). Individuals deemed to be unsuitable candidates for Rifampin-containing drug regimens (e.g. patients on oral contraception or those using medications with potential for interaction with RIF) were placed on 9-INH. All groups had similar demographics and received identical follow-up care.

RESULTS:  Completion of therapy rates were as follows: 2-RZ 77% (106 completed therapy/138 started therapy), 4-RIF 79% (166 completed therapy/209 started therapy), 9-INH 62% (41 completed therapy/66 started therapy). Statistical comparison: 4-RIF vs. 9-INH p < 0.01; 2-RZ vs. 9-INH p < 0.05; 4-RIF vs. 2-RZ-not significant. There were no significant adverse drug effects or deaths in any group.

CONCLUSION:  In this mobile population, the shorter LTBI treatment course of 4-RIF was well accepted, demonstrated no hepatic toxicity and contributed to a higher completion of therapy rate then the preferred 9-INH.

CLINICAL IMPLICATIONS:  Shorter course regimens contribute to improved completion of therapy rates in foreign-born persons recently arrived from high TB prevalence countries who have LTBI.

DISCLOSURE:  Lewis Mooney, None.

Tuesday, November 1, 2005

10:30 AM - 12:00 PM


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