Adverse events associated with weekly short course isoniazid and
rifapentine therapy in pediatric patients with latent tuberculosis: a
chart and literature review
Abstract
Background: Effective yet safe treatment of latent tuberculosis is
important for preventing the spread of tuberculosis and the progression
to active disease in pediatric patients. As of 2017, the short course
combination regimen of weekly isoniazid and rifapentine (3HP)
administered by directly observed therapy (DOT) has replaced 9 months of
isoniazid as the standard of treatment for latent tuberculosis in
pediatric patients. The literature, limited in size, has established the
3HP regimen’s superior safety and adherence. Methods: We completed a
retrospective chart review (n = 22) of pediatric patients at our
institution receiving this regimen between 2017 and 2019. Frequencies of
selected outcomes were compared to data collected in a literature
review. Results: In this retrospective chart review, pediatric patients
ages 2 to 20 years receiving 3HP with DOT for latent tuberculosis
experienced higher adverse event rates, more severe adverse events, and
higher treatment discontinuation than that which has been previously
reported in the literature. A possible explanation for this finding is
that our cohort’s race/ethnicity differed from the cohorts used in the
literature. Conclusions: Our data suggests that the short course
combination regimen for pediatric latent tuberculosis patients may have
a higher adverse event rate than previously established. Although this
sample size is small, this study urges further investigation of more
diverse cohorts to better establish the regimen’s safety and
tolerability.