Management of Latent Tuberculosis Infection Among Healthcare Workers: 10-Year Experience at a Single Center

Autor: Esther Arguello Perez, Susan K. Seo, Arthur E. Brown, Cynthia Eisenstein, William J. Schneider
Rok vydání: 2017
Předmět:
Microbiology (medical)
Adult
Male
medicine.medical_specialty
health care facilities
manpower
and services
Health Personnel
030231 tropical medicine
Population
education
Antitubercular Agents
Mycobacterium tuberculosis
03 medical and health sciences
0302 clinical medicine
Latent Tuberculosis
Internal medicine
medicine
Isoniazid
Humans
heterocyclic compounds
030212 general & internal medicine
Articles and Commentaries
Retrospective Studies
education.field_of_study
biology
Latent tuberculosis
business.industry
virus diseases
Disease Management
Retrospective cohort study
respiratory system
biochemical phenomena
metabolism
and nutrition
Middle Aged
bacterial infections and mycoses
biology.organism_classification
medicine.disease
Rifapentine
respiratory tract diseases
Discontinuation
Regimen
Infectious Diseases
Drug Therapy
Combination
Female
Rifampin
business
medicine.drug
Zdroj: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 65(12)
ISSN: 1537-6591
Popis: Background The risk of infection with Mycobacterium tuberculosis among healthcare workers (HCWs) is estimated to be higher than the general population. However, HCW acceptance and compliance with available latent tuberculosis infection (LTBI) treatment regimens has been problematic. Recently, regimens have become available that might improve HCW acceptance and compliance with LTBI treatment. Methods A retrospective single-center review of Employee Health and Wellness Services records of all HCWs diagnosed with LTBI was conducted. HCWs diagnosed with LTBI were offered 9-month isoniazid (INH), 4-month rifampin (RIF), weekly rifapentine/isoniazid (RPT/INH) for 12 weeks, or no treatment. Acceptance, completion rates, and side effects were reported for each regimen. Comparisons of regimens were assessed using Fisher exact test. Results Between 2005 and 2014, 363 of 927 (39%) HCWs diagnosed with LTBI accepted treatment. Of 363, 202 chose INH, 106 RIF, and 55 RPT/INH. Completion rates for each regimen were 58%, 80%, and 87%, respectively. HCWs were significantly more likely to have completed treatment with RIF (P < .0001) or RPT/INH (P < .0001) than INH. Rates of discontinuation owing to side effects were 35% for INH, 21% for RIF, and 10% for RPT/INH. Discontinuation of therapy due to side effects was significantly more frequent in the INH than the RPT/INH group (P = .0042). Conclusions Completion of RIF and RPT/INH for LTBI in an HCW population is more likely than INH. Rates of discontinuation due to side effects were lower among those taking RPT/INH. Shorter LTBI treatment regimens should be more widely considered for HCWs in the United States.
Databáze: OpenAIRE
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