TB: Not All Regimens Are Equal in Treated Exposed Health-Care Workers

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In ethnically diverse groups of hospital workers latent tuberculosis infection may need to be addressed. Exposure to Mycobacterium tuberculosis is higher in health care workers who were not born in the US. Reporting at ID Week 2015 in San Diego, Cal, researchers from Memorial Sloan Kettering Cancer Center said the hospital had more success with some treatment regimens for such workers than with others.

In ethnically diverse groups of hospital workers latent tuberculosis infection may need to be addressed. Exposure to Mycobacterium tuberculosis is higher in health care workers who were not born in the US. Reporting at ID Week 2015 in San Diego, CA, researchers from Memorial Sloan Kettering Cancer Center said the hospital had more success with some treatment regimens for such workers than with others. Esther Arguello Perez, MD and colleagues said that over a 10- year period, 930 health care workers at MSK were diagnosed with latent tuberculosis infection (LTBI). They were offered a choice of four treatment regimens.

Those were nine months of daily isoniazid (INH) alone; four months of daily rifampin alone; three months of once weekly rifapentine/INH (R/I), or no treatment.

The results showed that overall, 357 workers accepted treatment for LTBI and 273 of those completed it. Of these 56.6% chose INH; 104 chose rifampin; 51 chose R/I.Most chose no treatment.

The workers were significantly more likely to complete treatment with either rifampin (83.6%) or R/I (88.2%) than with just INH (69.8%).

The team concluded that “Consideration should be given to no longer routinely recommending INH for the treatment of LTBI in health care workers,” and that “additional awareness and usage of these two alternative regimen may also improve workers’ acceptance of treatment for LTBI.”

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