What is the efficacy of isoniazid for tuberculosis (TB) treatment?
Nine months of Isoniazid is a regimen that has been historically used for the treatment of LTBI. Clinical studies of this regimen have indicated it can be ~95% effective in preventing progression to active TB with full compliance in immunocompetent subjects.
Is there an optimal treatment regimen for patients with INH-resistant tuberculosis (TB)?
No definitive randomized or controlled studies have been performed to date that have determined the optimal treatment regimen for patients with INH-resistant TB. Thus, in this chapter, we describe key studies on the management of INH-resistant TB.
Can you take isoniazid 2 times a week?
Note: When isoniazid is to be taken 2 times a week, it should be given by directly observed therapy (DOT).* IF YOU FORGET TO TAKE YOUR MEDICINE: If it is still the same day, take the dose as soon as you remember.
How often should tuberculosis (TB) be given?
Medically reviewed by Drugs.com. Last updated on Oct 6, 2021. -Doses given 2 or 3 times a week should be given via directly observed therapy (DOT). -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis.
How long is treatment with isoniazid?
Treatment Regimens for Latent TB Infection (LTBI)Drug(s)DurationFrequencyIsoniazid (INH)* and Rifapentine (RPT)†3 monthsOnce weeklyRifampin (RIF)§4 monthsDailyIsoniazid (INH)* and Rifampin)§3 monthsDailyIsoniazid (INH)6 monthsDaily3 more rows
How long is isoniazid taken for TB?
To help clear up your tuberculosis (TB) completely, it is very important that you keep taking this medicine for the full time of treatment, even if you begin to feel better after a few weeks. You may have to take it every day for as long as 6 months to 2 years.
How many months TB treatment should take?
Most people with TB disease will need to take TB medicine for at least 6 months to be cured.
Is 6 months TB treatment enough?
tuberculosis to other persons. To ensure that these goals are met, TB disease must be treated for at least 6 months and in some cases even longer. Most of the bacteria are killed during the first 8 weeks of treatment; however, there are persistent organisms that require longer treatment.
Why do I have to take isoniazid for 9 months?
A 9-month course of isoniazid monotherapy is currently recommended for the treatment of latent tuberculosis infection (LTBI) and has been shown to be effective in both children and adults. Reduced compliance with this regimen has forced physicians to explore shorter regimens.
What happens if I stop taking isoniazid?
Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Isoniazid will not treat a viral infection such as the flu or a common cold. Your liver function may need to be checked every month while you are taking this medicine.
When can I stop anti TB medication?
If it is thought that the liver disease is caused by the anti-TB drugs, all drugs should be stopped. If the patient is severely ill with TB and it is considered unsafe to stop TB treatment, a non-hepatotoxic regimen consisting of streptomycin, ethambutol and a fluoroquinolone should be started.
Can tuberculosis come back after treatment?
A recurrence of TB can be due to relapse or re-infection [1]. To prevent relapse, TB treatment guidelines in the United States (U.S.) recommend extended treatment for TB cases with cavities on chest radiograph and delayed bacterial clearance from sputum [2]. Re-infection is prevented when TB transmission is averted.
Why is TB treatment so long?
A long treatment is required because antibiotics work only when the bacteria are actively dividing, and the bacteria that cause TB can rest without growing for long periods. This treatment is necessary to keep the latent TB infection from developing into active disease.
Can TB be cured in 2 months?
Brief Summary: Tuberculosis (TB) is a serious infection that can affect the lungs and other parts of the body. The usual way to treat TB is to take 4 medicines by mouth every day for 2 months, then take 2 of the same medicines for 4 more months, for a total of 6 months.
How long is treatment for latent TB?
A course of antibiotic medicine will treat latent TB. You may be given Rifampicin and Isoniazid for three months (which may be together in a tablet called Rifinah) or Isoniazid by itself for six months. Your doctor or TB specialist nurse will talk you through the treatment and answer any questions you may have.
How do you know you are healed from TB?
Testing at 5 or 7 months will show if the patient has been cured of TB. It is a wonderful achievement when the patient completes the full course of medication but proof of cure must be obtained through the patient giving that final sputum.
Usual Adult Dose for Tuberculosis - Extrapulmonary
Pulmonary Tuberculosis without HIV Infection: OPTION 1: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 5 mg/kg orally once a day (maximum 300 mg/day) OR 15 mg/kg orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 2: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 3: 15 mg/kg orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months Extrapulmonary Tuberculosis: Daily dosing: 5 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 15 mg/kg orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via directly observed therapy (DOT). -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations: Up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week Over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations: LATENT TUBERCULOSIS: Preferred therapy: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative therapy: 15 mg/kg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 5 mg/kg orally once a day PLUS rifampin/rifabutin, ethambutol, and pyrazinamide -Duration of therapy: 2 months Continuation Phase: 5 mg/kg orally once a day for 5 to 7 days per week PLUS rifampin/rifabutin Duration of therapy: -Extrapulmonary in other sites: 6 months -Pulmonary, drug susceptible: 6 months -Extrapulmonary with bone/joint involvement: 6 to 9 months -Pulmonary and positive culture at 2 months of treatment: 9 months -Extrapulmonary with central nervous system involvement: 9 to 12 months DRUG-RESISTANT TUBERCULOSIS: Initial phase: 5 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, ethambutol, rifampin/rifabutin, pyrazinamide, and an aminoglycoside/capreomycin Comments: -Pyridoxine 25 to 50 mg orally should be given to patients during treatment for latent tuberculosis. -If the organism is susceptible to this drug and rifampin, ethambutol may be discontinued during the intensive phase. -DOT is recommended for patients with HIV-related tuberculosis. Uses: -Preferred treatment to prevent tuberculosis in patients with a positive screening test for latent tuberculosis infection, no evidence of active tuberculosis, and no prior history of treatment for active or latent tuberculosis -Preferred treatment to prevent tuberculosis in patients with close contact with a person with infectious tuberculosis, regardless of a screening test result -First-line drug for the treatment of active tuberculosis caused by Mycobacterium tuberculosis.
Usual Adult Dose for Tuberculosis - Active
Pulmonary Tuberculosis without HIV Infection: OPTION 1: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 5 mg/kg orally once a day (maximum 300 mg/day) OR 15 mg/kg orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 2: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 3: 15 mg/kg orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months Extrapulmonary Tuberculosis: Daily dosing: 5 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 15 mg/kg orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via directly observed therapy (DOT). -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations: Up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week Over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations: LATENT TUBERCULOSIS: Preferred therapy: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative therapy: 15 mg/kg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 5 mg/kg orally once a day PLUS rifampin/rifabutin, ethambutol, and pyrazinamide -Duration of therapy: 2 months Continuation Phase: 5 mg/kg orally once a day for 5 to 7 days per week PLUS rifampin/rifabutin Duration of therapy: -Extrapulmonary in other sites: 6 months -Pulmonary, drug susceptible: 6 months -Extrapulmonary with bone/joint involvement: 6 to 9 months -Pulmonary and positive culture at 2 months of treatment: 9 months -Extrapulmonary with central nervous system involvement: 9 to 12 months DRUG-RESISTANT TUBERCULOSIS: Initial phase: 5 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, ethambutol, rifampin/rifabutin, pyrazinamide, and an aminoglycoside/capreomycin Comments: -Pyridoxine 25 to 50 mg orally should be given to patients during treatment for latent tuberculosis. -If the organism is susceptible to this drug and rifampin, ethambutol may be discontinued during the intensive phase. -DOT is recommended for patients with HIV-related tuberculosis. Uses: -Preferred treatment to prevent tuberculosis in patients with a positive screening test for latent tuberculosis infection, no evidence of active tuberculosis, and no prior history of treatment for active or latent tuberculosis -Preferred treatment to prevent tuberculosis in patients with close contact with a person with infectious tuberculosis, regardless of a screening test result -First-line drug for the treatment of active tuberculosis caused by Mycobacterium tuberculosis.
Usual Adult Dose for Tuberculosis - Latent
Pulmonary Tuberculosis without HIV Infection: OPTION 1: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 5 mg/kg orally once a day (maximum 300 mg/day) OR 15 mg/kg orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 2: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 3: 15 mg/kg orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months Extrapulmonary Tuberculosis: Daily dosing: 5 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 15 mg/kg orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via directly observed therapy (DOT). -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations: Up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week Over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations: LATENT TUBERCULOSIS: Preferred therapy: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative therapy: 15 mg/kg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 5 mg/kg orally once a day PLUS rifampin/rifabutin, ethambutol, and pyrazinamide -Duration of therapy: 2 months Continuation Phase: 5 mg/kg orally once a day for 5 to 7 days per week PLUS rifampin/rifabutin Duration of therapy: -Extrapulmonary in other sites: 6 months -Pulmonary, drug susceptible: 6 months -Extrapulmonary with bone/joint involvement: 6 to 9 months -Pulmonary and positive culture at 2 months of treatment: 9 months -Extrapulmonary with central nervous system involvement: 9 to 12 months DRUG-RESISTANT TUBERCULOSIS: Initial phase: 5 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, ethambutol, rifampin/rifabutin, pyrazinamide, and an aminoglycoside/capreomycin Comments: -Pyridoxine 25 to 50 mg orally should be given to patients during treatment for latent tuberculosis. -If the organism is susceptible to this drug and rifampin, ethambutol may be discontinued during the intensive phase. -DOT is recommended for patients with HIV-related tuberculosis. Uses: -Preferred treatment to prevent tuberculosis in patients with a positive screening test for latent tuberculosis infection, no evidence of active tuberculosis, and no prior history of treatment for active or latent tuberculosis -Preferred treatment to prevent tuberculosis in patients with close contact with a person with infectious tuberculosis, regardless of a screening test result -First-line drug for the treatment of active tuberculosis caused by Mycobacterium tuberculosis.
Usual Adult Dose for Tuberculosis - Prophylaxis
Adults over 30 kg: 300 mg orally once a day Duration of therapy: -Close contact with newly diagnosed tuberculosis patients: At least 12 weeks -Fibrotic pulmonary lesions or pulmonary silicosis: 12 months (or 4 months PLUS rifampin) -Patients with HIV: At least 12 months Comments: -Bacteriologically positive or radiographically progressive tuberculosis should be excluded before starting treatment. -Pyridoxine is recommended in patients who are malnourished and those at risk of neuropathy (e.g., alcoholics, patients with diabetes). -IM formulations may be used when oral administration is not possible. Uses: Preventive therapy in: -Close contacts of persons with newly diagnosed infectious tuberculosis -IV drug users known to be HIV-seronegative -Patients with HIV infection and persons with risk factors for HIV infection whose status is unknown, but who are suspected of having HIV infection -Patients with the following medical conditions: clinical situations associated with substantial rapid weight loss/chronic undernutrition (e.g., carcinomas of the upper oropharynx and upper gastrointestinal tract that prevent adequate nutritional intake, chronic malabsorption syndromes, chronic peptic ulcer disease, intestinal bypass surgery, postgastrectomy state with/without weight loss), diabetes mellitus, end-stage renal disease, immunosuppressive therapy, prolonged adrenocorticosteroid therapy, silicosis, some hematologic and reticuloendothelial diseases (e.g., leukemia, Hodgkin's lymphoma) -Patients younger than 35 years in high-incidence groups (e.g., foreign-born patients from high-prevalence countries who never received bacilli Calmette-Guerin [BCG] vaccine, medically underserved, low-income populations, including high-risk racial or ethnic minority populations, especially blacks, Hispanics, and Native Americans, and residents of facilities for long-term care [e.g., correctional institutions, nursing homes, mental institutions]) -Patients younger than 35 years with a tuberculin skin test reaction of 15 mm or more -Persons with abnormal chest radiographs that show fibrotic lesions likely to represent old healed tuberculosis or pulmonary silicosis -Recent converters (e.g., tuberculin skin test with 10 mm or greater (younger than 35 years) OR 15 mm or greater (35 years and older) within a 2-year period) US HHS, NIH, HRSA, and US CDC Recommendations: Preferred choice: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative choice: 900 mg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks Comments: -Patients receiving intermittent dosing should be given doses via DOT. -Pyridoxine 25 to 50 mg orally once a day should be given with this drug. Uses: -Prophylaxis to prevent the first episode of tuberculosis in patients with a positive screening test for latent tuberculosis infection, with no evidence of active tuberculosis, and no prior treatment for active or latent tuberculosis -Prophylaxis to prevent the first episode of tuberculosis in patients with close contact with a person with infectious tuberculosis, with no evidence of active tuberculosis, regardless of screening test results.
Usual Adult Dose for Mycobacterium kansasii
ATS and IDSA Recommendations: 5 mg/kg orally once a day Maximum dose: 300 mg/day Duration of therapy: 18 months Comment: Patients should have at least 12 months of negative sputum cultures. Use: Treatment of Mycobacterium kansasii pulmonary disease
Usual Pediatric Dose for Tuberculosis - Extrapulmonary
PULMONARY TUBERCULOSIS WITHOUT HIV INFECTION: Option 1: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) OR 20 to 40 mg/kg IM or orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 2: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 3: 20 to 40 mg/kg IM or orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months EXTRAPULMONARY TUBERCULOSIS: Daily dosing: 10 to 15 mg/kg IM or orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 40 mg/kg IM or orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via DOT. -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Academy of Pediatrics (AAP) Recommendations: Infants, Children, and Adolescents: Daily dosing: 10 to 15 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 30 mg orally 2 times a week -Maximum dose: 900 mg/dose Duration of therapy: -Latent tuberculosis (drug-susceptible): 9 months -Pulmonary and extrapulmonary tuberculosis (except meningitis): 2 months (3-drug regimen), then 4 months for drug-susceptible M tuberculosis OR 9 to 12 months for drug-susceptible Mycobacterium bovis -Meningitis: 2 months (4-drug regimen), followed by 7 to 10 months of this drug and rifampin (once a day or 2 times a week) Comments: -Daily treatment is preferred for latent tuberculosis; however, DOT may be used if daily treatment is not possible. -Patients who receive a 3-drug regimen (e.g., this drug, rifampin, and pyrazinamide) should have a low risk of drug resistance. -Patients with only hilar adenopathy and a low risk of drug resistance may receive treatment with this drug and rifampin for 6 months. -Patients with meningitis caused by M bovis should receive treatment with this drug, rifampin, and an aminoglycoside or ethionamide for 2 months, followed by at least 7 to 10 months of this drug and rifampin. Uses: -Treatment of latent Mycobacterial tuberculosis infection (e.g., positive tuberculin skin tests or interferon-gamma release assay result, no disease) -Treatment of pulmonary and extrapulmonary Mycobacterial tuberculosis infection (except meningitis) caused by M tuberculosis or M bovis -Treatment of meningitis caused by M tuberculosis or M bovis ATS, US CDC, and IDSA Recommendations: Less than 15 years OR up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week 15 years and older AND/OR over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US HHS, NIH, HRSA, and US CDC Recommendations: Children: DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 10 to 15 mg/kg orally once a day PLUS rifampin, pyrazinamide, and ethambutol Maximum dose: 300 mg/day Duration of therapy: 2 months Continuation Phase: 10 to 15 mg/kg (up to 300 mg/day) orally once a day PLUS rifampin OR 20 to 30 mg/kg IM or orally 3 times a week Duration of therapy: -Bone/joint disease or meningitis: Up to 10 months -Intrathoracic disease, lymph node tuberculosis: 7 months -Minimal disease and in the absence of significant immune compromise: 4 months Comment: The total duration of treatment is at least 12 months for minimal disease, and 18 to 24 months after non-bacteriological diagnosis or after culture conversion. Uses: -First-line drug for the treatment of active tuberculosis caused by M tuberculosis -Alternative drug (as part of a 3-drug regimen) for the treatment of fully drug-susceptible tuberculosis in the absence of significant immune compromise.
Usual Pediatric Dose for Tuberculosis - Active
PULMONARY TUBERCULOSIS WITHOUT HIV INFECTION: Option 1: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) OR 20 to 40 mg/kg IM or orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 2: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 3: 20 to 40 mg/kg IM or orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months EXTRAPULMONARY TUBERCULOSIS: Daily dosing: 10 to 15 mg/kg IM or orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 40 mg/kg IM or orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via DOT. -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Academy of Pediatrics (AAP) Recommendations: Infants, Children, and Adolescents: Daily dosing: 10 to 15 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 30 mg orally 2 times a week -Maximum dose: 900 mg/dose Duration of therapy: -Latent tuberculosis (drug-susceptible): 9 months -Pulmonary and extrapulmonary tuberculosis (except meningitis): 2 months (3-drug regimen), then 4 months for drug-susceptible M tuberculosis OR 9 to 12 months for drug-susceptible Mycobacterium bovis -Meningitis: 2 months (4-drug regimen), followed by 7 to 10 months of this drug and rifampin (once a day or 2 times a week) Comments: -Daily treatment is preferred for latent tuberculosis; however, DOT may be used if daily treatment is not possible. -Patients who receive a 3-drug regimen (e.g., this drug, rifampin, and pyrazinamide) should have a low risk of drug resistance. -Patients with only hilar adenopathy and a low risk of drug resistance may receive treatment with this drug and rifampin for 6 months. -Patients with meningitis caused by M bovis should receive treatment with this drug, rifampin, and an aminoglycoside or ethionamide for 2 months, followed by at least 7 to 10 months of this drug and rifampin. Uses: -Treatment of latent Mycobacterial tuberculosis infection (e.g., positive tuberculin skin tests or interferon-gamma release assay result, no disease) -Treatment of pulmonary and extrapulmonary Mycobacterial tuberculosis infection (except meningitis) caused by M tuberculosis or M bovis -Treatment of meningitis caused by M tuberculosis or M bovis ATS, US CDC, and IDSA Recommendations: Less than 15 years OR up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week 15 years and older AND/OR over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US HHS, NIH, HRSA, and US CDC Recommendations: Children: DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 10 to 15 mg/kg orally once a day PLUS rifampin, pyrazinamide, and ethambutol Maximum dose: 300 mg/day Duration of therapy: 2 months Continuation Phase: 10 to 15 mg/kg (up to 300 mg/day) orally once a day PLUS rifampin OR 20 to 30 mg/kg IM or orally 3 times a week Duration of therapy: -Bone/joint disease or meningitis: Up to 10 months -Intrathoracic disease, lymph node tuberculosis: 7 months -Minimal disease and in the absence of significant immune compromise: 4 months Comment: The total duration of treatment is at least 12 months for minimal disease, and 18 to 24 months after non-bacteriological diagnosis or after culture conversion. Uses: -First-line drug for the treatment of active tuberculosis caused by M tuberculosis -Alternative drug (as part of a 3-drug regimen) for the treatment of fully drug-susceptible tuberculosis in the absence of significant immune compromise.
How to treat latent TB?
Go to your planned clinic visits. Discuss any alcohol use with your doctor. Alcohol use may cause side effects. Tell your doctor about all other medicines you are taking. Be sure to tell your other doctors that you are being treated for latentTB infection.
How to take medicine at the same time?
Ask a family member or friend to remind you. Use a pillbox. Put a reminder note on your mirror or refrigerator. Use a calendar to check off the day when you take your medicine.
How to take a pill?
Tips to Help You Take Your Medicine: 1 Take your medicine at the same time every day. 2 Set an alarm reminder for the time you should take your medicine. 3 Ask a family member or friend to remind you. 4 Use a pillbox. 5 Put a reminder note on your mirror or refrigerator. 6 Use a calendar to check off the day when you take your medicine.