Resources and Information for Professionals
Treatment Options
There are three options for treatment recommended by CDC and National Tuberculosis Controllers Association (NTCA) are medications but taken in different combinations and/or different length of time. Treatment options are selected based on patient’s overall state of health, effectiveness of medication and regimen that will provide the least hepatoxicity or damage to the liver.
The three recommended medication combinations are:
- isoniazid and rifapentine weekly for 3 months
- Adults and children >2 years old, HIV positive patients are able to take this regimen through direct observation therapy and has the highest rates of completion (Fox et al., 2017; Sterling et al., 2020).
- Downfalls to this regimen is cost and the number of pills that need to be taken at one time; 10 pills compared to 2-3 in other regimens (Sterling et al., 2020).
- rifampin daily for 4 months
- Preferred treatment for HIV-negative adults and children of all ages, has the lowest rate of hepatoxicity, and high rate of completion (Fox et al., 2017; Sterling et al., 2020).
- Downfalls to this regimen is that there are many drug interactions with warfarin, oral contraceptives, azole antifungals, HIV antiviral therapy (Sterling et al, 2020).
- isoniazid and rifampin daily for 3 months (Sterling et al., 2020).
- Recommended for HIV-positive adults and children
- Downfalls for this treatment is that patients tend to discontinue treatment due to adverse side effects (Sterling et al., 2020).
Fox, G., Dobler, C., Marais, B., & Denholm, J. (2017). Preventive Therapy for Latent Tuberculosis Infection—the Promise and the Challenges. International Journal of Infectious Diseases, 56, 68-76. doi:10.1016/j.ijid.2016.11.006
Sterling, T., Njie, G., Zenner, D., Cohn, D., Reves, R., Ahmed, A., … Belknap, R. (2020). Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recommendations & Reports, 69(1): 1-11. http://web.b.ebscohost.com.proxy.lib.ohio-state.edu/ehost/pdfviewer/pdfviewer?vid=12&sid=d8fb7fe7-b6c4-42d1-ad01-7dcabe316909%40pdc-v-sessmgr03
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Let your patients know that if they are told they have LTBI, they are not alone.
Here are a list of resources that you can share with patients to help
explain and alleviate the stress and anxiety surrounding LTBI.
Difference between TB and Latent TB