10 Años innovando en el tratamiento de la infección tuberculosa latente: comparación entre pautas estándar y pautas cortas en tratamiento directamente observado

Abstract

Greater acceptance of initiating therapy was observed in all the DOT therapies. The 3RH, 2R2Z2 and 4R short course therapies favoured better adherence, with significantly lower ratios of withdrawal than the 9H therapy for the treatment of latent tuberculosis infection. Tolerance and safety of the short course therapies was very similar to the standard 9H treatment, with a significantly higher percentage of adverse reactions in the 2R2Z2 therapy in comparison to others. Our data backs up the safety and adherence of a short course 3RH therapy in DOT for treating latent tuberculosis infection and its preferential use in the prison environment in comparison to isoniazid due to the greater number of patients concluding treatment. The administration of LBTI therapy in DOT achieves a high percentage of acceptance and conclusion of treatments in prison, significantly improving on the previous results in a cross-sectional study of the prison environment and others obtained at our centre in self-administered treatment.

Isoniazid use, effectiveness, and safety for treatment of latent tuberculosis infection: a systematic review

“…Three of the included studies did not report where they were conducted 54 , 62 , 88 . The most frequent settings were: outpatient clinics and clinics (n = 41) 24 - 26 , 30 , 35 - 38 , 40 - 43 , 46 - 52 , 56 - 58 , 61 , 67 , 68 , 71 - 73 , 75 , 81 , 82 , 84 , 85 , 87 , 89 - 95 ; hospitals (n =19) 24 , 28 , 39 , 40 , 45 , 53 , 55 , 59 , 60 , 64 , 66 , 70 , 74 , 76 , 77 , 80 , 78 , 79 , 83 ; and penitentiaries (n = 4) 29 , 31 , 33 , 63 .…”

“…Most of the included studies (n = 49) did not specify patient profiles 24 - 33 , 35 - 37 , 40 - 44 , 47 , 49 , 51 , 52 , 54 , 55 , 57 - 59 , 60 , 63 - 65 , 67 , 68 , 70 , 71 , 77 , 79 , 81 - 87 , 89 , 90 , 93 , 94 , four studies involved patients with inflammatory bowel disease or immune-mediated inflammatory diseases 72 , 73 , 76 , 80 , four involved human immunodeficiency virus (HIV)-positive adults 56 , 61 , 74 , 91 , four involved patients who transplanted or had transplants 34 , 50 , 62 , 66 , and six involved health professionals 38 , 39 , 45 , 48 , 78 , 88 .…”

“…Regarding the various treatment alternatives for LTBI globally, among the studies analyzed, 53 used INH for 9 months 24 - 28 , 30 - 34 , 38 - 46 , 49 - 54 , 58 , 61 , 63 , 64 , 67 , 69 , 72 - 74 , 76 , 77 - 79 , 80 , 81 , 82 - 87 , 89 , 91 , 92 , 94 , 95 , 40 used INH for 6 months 24 , 26 , 27 , 29 , 34 - 36 , 39 , 42 - 44 , 47 - 49 , 53 , 55 , 56 , 57 , 59 - 62 , 64 , 65 , 67 , 68 , 70 , 71 , 72 , 74 , 75 , 84 , 86 - 90 , 93 , 94 , 95 , and two used INH for 12 months 66 . Rifampicin monothera...…”

“…Among the combination therapies for LTBI, 11 studies used INH + rifampicin 49 , 63 , 71 , 74 - 76 , 78 , 79 , 81 , 88 , 90 , 10 used INH + rifapentine 28 , 30 , 31 , 33 , 42 , 45 , 49 , 50 , 52 , 83 , eight used rifampicin + pyrazinamide 24 , 29 , 43 , 47 , 51 , 63 , 68 , 89 , and three used rifampicin + INH + pyrazinamide + ethambutol 46 , 49 , 74 . The drug combinations that were used less frequently for TB prophylaxis were rifampicin + INH 24 , 40 , 67 , rifampicin + ethambutol 70 , and rifampicin + INH + pyrazinamide 24 , 68 , 74 .…”

ESMPE: A combined strategy for school tuberculosis prevention and control proposed by Dalian, China

“…Hence, the relative low rate of LTBI students who had completed preventive treatment probably reflects the unsatisfactory efficacy in witnessing the prescription of anti-TB drugs from poorly trained volunteer. In addition, fear of the adverse event due to the medication of preventive treatment is another important reason for the interruption of preventive treatment [ 16 ]. In view of the great threat posed by school cluster epidemic, more attention should be paid on the manage the LTBI students to reduce the potential emergence of new cases and further outbreak in this population.…”