Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/cep.2021.01186    [Accepted]
Published online October 29, 2021.
Four months of rifampicin monotherapy for latent tuberculosis infection in children
Chi Eun Oh1  , Dick Menzies2 
1Department of Pediatrics, Kosin University College of Medicine, Busan, Korea
2Respiratory Epidemiology and Clinical Research Unit, McGill International TB Centre, McGill University, Montréal, Québec, Canada
Correspondence: 
Dick Menzies, Email: dick.menzies@mcgill.ca
Received: 11 August 2021   • Revised: 5 October 2021   • Accepted: 14 October 2021
Abstract
Diagnosing and treating latent tuberculosis infection (LTBI) is an important part of efforts to combat TB. The Korean guidelines for TB published in 2020 recommend two LTBI regimens for children and adolescents: nine months of daily isoniazid (9H) and three months of daily isoniazid plus rifampicin. Isoniazid for 6–12 months has been used to effectively treat LTBI in children for over 50 years. However, a long treatment period results in poor patient compliance. This review summarizes pediatric data on the treatment completion rate, safety, and efficacy of four months of daily rifampicin (4R) and evaluates the pharmacokinetics and pharmacodynamics of rifampicin in children. The 4R regimen has a higher treatment completion rate than the 9H regimen and equivalent safety in children. The efficacy of preventing TB is also consistent with that of 9H when summarizing reports published to date. A shorter treatment period could increase patient compliance and, therefore, prevent TB in more patients. By using an effective, safe, and highly compliant regimen for the treatment of children with LTBI, we would become one step closer to our goal of eradicating TB.
Key Words: Child, Latent tuberculosis, Patient compliance , Rifampicin


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