Hello, current guidelines support a 9 months treatment with isoniazid for latent infection in immunocompromised hosts. It has similar efficacy as 12 months therapy, but about 20-30% higher efficacy than a 6 months regimen.
Hello, i presume to wait for 9 months may be imprudent. A bridged course of high dose rifampcin 600 mg daily or 900 my alternate day for 4.5 months may prove equally efficatious if not less.
Isoniazid for a period of 9 months is the most commonly used regimen and has an estimated efficacy of around 90%. Some studies indicate that 4 months of rifampicin (4R) are at least as effective as 3HR (around 60%) and this regime has the advantage of being better accepted by patients, having fewer adverse effects when compared with regimens based on isoniazid and is associated with a lower cost to the health system. I think you don't need to wait for 9 months to do a bone marrow transplant. In patients candidate for anti-TNF treatment, we allow the introduction of anti-TNF after 1 month of isoniazid.
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