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Treating latent tuberculosis infection :-
Isoniazid is used for treating LTBI. Typically, isoniazid 300 mg daily (5–10 mg/kg of body weight) is given alone for 9 months. Lower doses usually are less effective. In some instances, a 6 month duration of treatment with isoniazid alone is an acceptable alternative. Pyridoxine (25–50 mg/day in adults) can reduce the risk of peripheral neuropathy. Treatment of LTBI reduces a person’s lifetime risk of active TB from about 10% to about 1%. Rifampin 600 mg daily for 4 months can be used when isoniazid resistance is suspected or when the patient cannot tolerate isoniazid. Rifabutin 300 mg daily might be substituted for rifampin in patients at high risk of drug interactions. The combination of pyrazinamide and rifampin is no longer recommended. Once-weekly doses of isoniazid 900 mg and rifapentine 900 mg given as DOT for 3 months are as effective as 9 months of self-administered isoniazid 300 mg daily. When resistance to isoniazid and rifampin is suspected, there is no regimen proven to be effective . Note that patients with LTBI are not infectious and there is no isolate on which to perform susceptibility testing. Susceptibility patterns must be inferred based on the most likely source of infection.
( ph.therapy principles page 1126 )
