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Treatment options favorable for children with latent TB infection
The decision to treat children with latent tuberculosis infection is easy because of the favorable risk-to-benefit ratio compared with adults, according to study results published in the Journal of Pediatric Infectious Diseases Society.
“Treatment of latent tuberculosis infection is the most effective strategy to prevent future cases of disease,” researchers wrote. “Most cases of childhood TB disease in low-prevalence countries are preventable by screening for risk factors, testing for [latent tuberculosis infection], and offering therapy. Although [latent tuberculosis infection] therapy has been available and emphasized in industrialized nations, its use has been limited in most resource-limited settings.”
Andrea Cruz
Researchers examined pediatric and adult studies of latent tuberculosis infection (LTBI) treatment, including: isoniazid andrifampin monotherapy; isoniazid plus rifampin; isoniazid plus rifapentine (Priftin, Sanofi-Aventis); and rifampin plus pyrazinamide.
CDC currently recommends 9 months of isoniazid as the preferred treatment for children, but the completion rate of treatment is often less than 50%. Researchers recommend shorter regimen treatments to increase rates of adherence.
They said for children aged 12 years and older, 12 weekly doses of isoniazid and rifapentine may be a better option. The next alternative is 4 months of rifampin.
Other less known regimens also are accepted, including 3 months of daily isoniazid and rifampin or 6 months of isoniazid.
“The decision to initiate therapy for LTBI in children is made easier by the very favorable risk/benefit ratio compared with adults: Risks are minimized because children tolerate TB medications better than adults, and children benefit more because they have increased risk of progression to disease,” researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
