Management of latent tuberculosis infection among healthcare workers: 10-year experience at a single center Journal Article
| Authors: | Arguello Perez, E.; Seo, S. K.; Schneider, W. J.; Eisenstein, C.; Brown, A. E. |
| Article Title: | Management of latent tuberculosis infection among healthcare workers: 10-year experience at a single center |
| Abstract: | 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. © 2017 The Author. Published by Oxford University Press for the Infectious Diseases Society of America. |
| Keywords: | adult; antibiotic therapy; fatigue; hepatitis; drug withdrawal; side effect; unspecified side effect; united states; liver toxicity; allergy; neuropathy; medical record review; retrospective study; aminotransferase blood level; rash; bilirubin; hospitalization; disease severity; health care personnel; flu like syndrome; weakness; headache; aminotransferase; rifampicin; bilirubin blood level; urticaria; eye irritation; rifapentine; bcg vaccination; pyridoxine; isoniazid; rifampin; healthcare workers; latent tuberculosis; human; male; female; priority journal; article; latent tuberculosis infection |
| Journal Title: | Clinical Infectious Diseases |
| Volume: | 65 |
| Issue: | 12 |
| ISSN: | 1058-4838 |
| Publisher: | Oxford University Press |
| Date Published: | 2017-12-15 |
| Start Page: | 2105 |
| End Page: | 2111 |
| Language: | English |
| DOI: | 10.1093/cid/cix725 |
| PROVIDER: | scopus |
| PUBMED: | 29020308 |
| PMCID: | PMC5850550 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 February 2018 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work