Isoniazid/acetylisoniazid urine concentrations: markers of adherence to isoniazid preventive therapy in children

Abstract

SUMMARY The Arkansas colorimetric method monitors adherence to isoniazid (INH) by the detection of INH metabolites in urine. Urine samples 4 h after INH administration in 31 human immunodeficiency virus infected children receiving daily or thrice weekly INH preventive therapy were Arkansas test-positive for 29/31 (94%), while acetylisoniazid (AcINH) was detected in 30/31 (97%) using mass spectrometry. At 24, 48 and 72 h, only 78%, 23% and 0 samples, respectively, were Arkansas-positive, while INH or AcINH was detected in respectively 94%, 69% and 33%. The Arkansas test reliably predicted INH ingestion at a clinic visit 4 h after morning doses, but did not perform well at 24 h.

Isoniazid preventive treatment among child contacts of adults with smear-positive tuberculosis in The Gambia

“…The sensitiv-ity of the IsoScreen test decreases with the passage of time from ingestion of the medication. 24 Similarly, some poorly adherent individuals may have taken IPT prior to their IsoScreen test. As the day for IsoScreen testing was not announced in advance, however, it is unlikely that differential bias was introduced.…”

Alternative Methods for Therapeutic Drug Monitoring and Dose Adjustment of Tuberculosis Treatment in Clinical Settings: A Systematic Review

“…TB: ND HV: 4 h, 8 h post-dose. TB: 8 h post-dose Colorimetry ND Correlation, receiver operator characteristic curve Moderate Rifapentine Sirgel et al [ 47 ] TB Study 1: 57; Study 2: 46 Study 1: 2 days before to 5 days after; study 2: day of visit Study 1: baseline, 24, 48, 72, 96, and 120 h post-dose; study 2: 2-h intervals for 8 h post-dose Study 1: microbiologic assay, visual detection after addition of chemicals; Study 2: HPLC N/A N/A Low Isoniazid Amlabu et al [ 49 ] IPT (pediatric) 41 Visit day 4 and 24 h after dose in daily therapy. 4, 48, and 72 h after dose in intermittent therapy.…”

Impact of nursing interventions on adherence to treatment with antituberculosis drugs in children and young people: A nonrandomized controlled trial

“…Patients are often reluctant to admit lack of adherence in clinical interviews and questionnaires (Svarstad et al., ). The Eidus–Hamilton test to detect isoniazid metabolites in urine is cheap, objective, sensitive, reproducible and can be performed in the outpatient clinic, in front of the patient (Amlabu et al., ; Meissner, Musoke, Okwera, Bunn, & Coulter, ; Palanduz, Gultekin, & Kayaalp, ; Sirgel et al., ; Whitfield & Cope, ). Despite these advantages, its use in children and young people has not been reported in the literature.…”