Completion rate of latent tuberculosis infection treatment in patients aged 65 years and older

Abstract

Introduction: There are insufficient data on the treatment of latent tuberculosis infection (LTBI) in elderly patients. We investigated the completion rate of treatment in elderly LTBI patients. Methods: A retrospective multicentre study was conducted at five university hospitals in South Korea. We reviewed the electronic medical records of patients aged 65 years and older who were diagnosed with LTBI via positive interferon-gamma release assay results between January 2016 and December 2018. Treatment completion was defined as ingestion of more than 80% of all prescribed medications without loss to follow-up. Results: During the study period, 127 LTBI patients aged 65 years and older visited outpatient department. Among them, 77 patients aged 65-78 years (median age, 69 years [interquartile range, 66-71 years]) who received LTBI treatment were analysed. Common reasons for IGRA testing in elderly patients were health-care worker (n = 33, 42.9%) and household contact with infectious TB patients (n = 18, 23.4%).The overall completion rate of LTBI treatment was 83.1% (n = 64), and the completion rate of 3-month isoniazid plus rifampin regimen was 88.4%. Adverse effects were reported in 23 patients (29.9%), and an increase in aminotransferase level was the most common adverse effect (n = 11, 14.3%). Three patients (3.9%) with the adverse effect discontinued treatment and 10 (13.0%) patients were lost to follow-up. Conclusions: LTBI treatment in patients aged 65-78 years was relatively well tolerated. In LTBI treatment in elderly patients, the majority of discontinuation of treatment was due to loss to follow-up rather than adverse effects of anti-TB medications.

Antimicrobial-associated Organ Injury among the Older Adults: A Systematic Review and Meta-Analysis

“…Figure 4 (additional le 5, document 1) is a funnel plot showing the distribution of the studies when the standard error was plotted against the proportion of cases, and gure 5 (additional le 5, document 1) shows the forest plot before removing outliers, with an absolute risk of 21.4% (95% CI: 17.1% -25.7%). After performing the leave-one-out meta-analysis, the overall absolute risk reduced signi cantly (p = 0.017) after excluding the study by Carreno et al (28). As shown in gure 6 (additional le 5, document 1), excluding other studies did not signi cantly impact the overall absolute risk of AKI.…”

“…Three of the ve studies determined the association of AKI due to glycopeptide treatment among those at least 80 years when compared to those between 65 and 79 years (25,28,30). According to Pan et al (25), there was a signi cant association of AKI among those at least 80 years old and on glycopeptide therapy when compared to those between 65 and 79 years of age, with a relative risk of 2.…”

“…Most hospital-based studies used tools that relied on laboratory markers for organ injury, such as a two-fold rise in serum creatinine or doubling of liver transaminases. Some of the tools used include the acute kidney injury network (AKIN) (16,21,23,28) and kidney disease, improving global outcome (KDIGO) (17,25,26). Only three studies (12,16,20) did not describe how they determined the absence of outcome of interest at the beginning of their studies.…”

The Effects of Levetiracetam as Anti-Epileptic Drug on Bone and Vitamin D Metabolism

“…However, these structural alterations were also found in epileptic rats compared to control rats which are reported in our previous study. 29 Thus, epilepsy and seizures may affect bone metabolism by another mechanism besides a decreased vitamin D amount. Further studies should elucidate these unknown mechanisms.…”

The Treatment of Latent Tuberculosis Infection: Province Based Practice and Problems

“…28 The completion rate of LTBI treatment in patients aged 65 years and older has been investigated and the competition rate was found as 83.1%. 29 In a study that evaluates 415 LTBI treatment initiated patients at a university hospital in Stockholm-Sweden, treatment completion rates in 2002 and 2007 were 71% and 87%; respectively, that indicated an increase in the rate for 5 years. 30 Contrary to this literature; in our study rates of completion of treatment declined from 4,6 86.4% in 2005 to 52% in 2013.…”