Errata: Vol. 60, No. 48 Weekly February 3, 2012 / 61(04);80 In the report, "Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection," errors occurred. On page 1653, in Box 2, the fourth bullet point should begin, "Baseline hepatic chemistry blood tests (at least alanine aminotransferase [ALT]) for patients with specific conditions:"
On page 1651, in the multination treatment trial described in the second full paragraph, the treating physicians had the option of prescribing oral pyridoxine 50 mg for administration with each dose of both the weekly isoniazid-rifapentine and the daily isoniazid-only regimens. Weekly pyridoxine 50 mg for prophylaxis of isoniazid-associated peripheral neuropathy should be considered with the isoniazid-rifapentine regimen, especially for persons who are malnourished or predisposed by other illnesses to peripheral neuropathy. |
Preventing tuberculosis (TB) by treating latent Mycobacterium tuberculosis infection (LTBI) is a cornerstone of the U.S. strategy for TB elimination (1,2). Three randomized controlled trials have shown that a new combination regimen of isoniazid (INH) and rifapentine (RPT) administered weekly for 12 weeks as directly observed therapy (DOT) is as effective for preventing TB as other regimens and is more likely to be completed than the U.S. standard regimen of 9 months of INH daily without DOT (2–5). This report provides CDC recommendations for using the INH-RPT regimen. The new regimen is recommended as an equal alternative to the 9-month INH regimen for otherwise healthy patients aged ≥12 years who have LTBI and factors that are predictive of TB developing (e.g., recent exposure to contagious TB). The new regimen also can be considered for other categories of patients when it offers practical advantages. Although the INH-RPT regimen was well tolerated in treatment trials, monitoring for adverse effects is recommended. Severe adverse effects should be reported to the Food and Drug Administration (FDA) and CDC.
Background
M. tuberculosis, a bacterium transmitted by airborne droplet nuclei from patients with respiratory forms of the disease, causes TB, a contagious and potentially fatal disease. TB develops in 5%–10% of persons who get infected with M. tuberculosis, typically after a latency of 6–18 months, but after decades in some persons. Conditions that impair cellular immunity, especially HIV infection, increase the likelihood of TB developing at any interval after infection. Treatment during latency prevents TB during treatment and afterward (2).
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