TUESDAY, June 16, 2020 (HealthDay News) — Greater health system use and higher costs are seen with nine months of isoniazid compared with four months of rifampin in both adults and children treated for latent tuberculosis infection, according to a study published online June 16 in the Annals of Internal Medicine.

Mayara Lisboa Bastos, M.D., from the State University of Rio de Janeiro, and colleagues compared health care use and associated costs of four months of rifampin and nine months of isoniazid based on all health care activities recorded during two randomized clinical trials. Data were included for 6,012 adults and 829 children with clinical or epidemiological factors associated with an increased risk for developing tuberculosis that warranted latent tuberculosis infection treatment.

The researchers found that nine months of isoniazid was associated with greater health system use and higher costs than four months of rifampin for both children and adults. The ratios of costs of four months of rifampin versus nine months of isoniazid were 0.76, 0.90, and 0.80 in high-income, middle-income, and African countries, respectively. In the pediatric population, similar findings were observed.

“Four months of rifampin is a safe, effective, and more affordable regimen compared with isoniazid monotherapy regimens,” the authors write. “Tuberculosis programs in all countries should consider adoption of the four-month rifampin regimen as a first-line therapy for latent tuberculosis infection.”

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