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Doctors call for change in how non-active TB in immigrant children treated
Date:3/2/2009

infectious disease specialist, and Stephen M. Downs, M.D., IU School of Medicine associate professor of pediatrics and a Regenstrief Institute affiliated scientist, determined that treatment guidelines need to be changed so that children with non-active TB who come to the U.S. from countries with high rates of isoniazid resistance are treated with another drug called rifampin. Rifampin currently is used only in children exposed to known cases of isoniazid resistant TB.

"As we can't find the actual bacteria in patients with non-active TB, we have no way of knowing which children have the isoniazid-resistant strain. Our analysis shows that for those with latent TB who come from countries with isoniazid-resistant rates above 11 percent, treatment with rifampin would be cost-effective. Even though rifampin is a more expensive drug than isoniazid, we would lower total costs because using rifampin would prevent more cases of active TB. As an added benefit, the course of rifampin is six months rather than the nine months of therapy required for isoniazid, which may improve adherence. In parts of the world, more than 40 percent of the active TB cases are now isoniazid resistant. We need to consider where a child came from, what the rate of resistance is in that country, and tailor the medication to that," said Dr. Finnell.

According to Dr. Finnell, there has been no previous analysis of this type for pediatric non-active TB patients, although similar analyses have been done for adults. And she notes that the benefits of treating non-active TB far exceed the minimal risk of side effect in children.


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Contact: Cindy Fox Aisen
caisen@iupui.edu
317-274-7722
Indiana University
Source:Eurekalert  

Page: 1 2

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