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A major goal for management of pulmonary tuberculosis (TB) is shortening treatment from the 6-month standard regimen to encourage adherence and reduce costs. In animal models, high-dose versus low-dose rifampin is more-rapidly bactericidal and better at eradicating persistent mycobacteria.
Investigators performed a multinational noninferiority trial comparing the 6-month regimen (2 months of isoniazid, ethambutol, pyrazinamide, and rifampin [10 mg/kg/day] followed by 4 months of isoniazid and rifampin) with two high-dose rifampin regimens (4 months of 1200- or 1800-mg/day rifampin given along with 4 months of isoniazid plus, for the first 2 months, ethambutol and pyrazinamide). Individuals were excluded if they had HIV, diabetes, hepatic or …