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For years, isoniazid (INH) has been the drug of choice to prevent latent tuberculosis infection (LTBI) from progressing to clinical disease. However, concerns about toxicity, resistance, and notoriously poor adherence to the usual 9-month course of INH have prompted interest in alternatives.
In a non-randomized retrospective study, researchers at a large New Jersey TB clinic compared rates of treatment completion among 213 patients treated with 9 months of prophylactic INH and 261 patients treated with 4 months of rifampin, an alternative regimen. Adherence rates during treatment were determined by monthly pill counts and patient report; INH recipients who completed at least 6 months of treatment were counted as successful.
Overall, the rate …