Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
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Two types of studies are available to test the hypothesis in human subjects<br />
that rifampicin with or without isoniazid is first, efficacious, <strong>and</strong> second,<br />
equivalent or better than isoniazid alone, even if given <strong>for</strong> shorter<br />
durations. The first type consists of comparisons of rifampicin <strong>and</strong><br />
rifampicin combinations with placebo, the second comparisons of rifampicin<br />
<strong>and</strong> rifampicin combinations with isoniazid (equivalence studies). The<br />
hypothesis <strong>and</strong> sample size requirements differ in the two approaches.<br />
Rifampicin <strong>and</strong> rifampicin combinations in comparison<br />
to placebo<br />
Studies comparing rifampicin (<strong>and</strong> combinations) with placebo have been<br />
carried out among patients with silicosis <strong>and</strong> patients with HIV infection<br />
(figure 87). 885,886,892<br />
In Kampala, Ug<strong>and</strong>a, two arms had rifampicin-containing regimens.<br />
Compared to placebo, daily rifampicin plus isoniazid <strong>for</strong> three months gave<br />
60% protection among tuberculin-positive patients with HIV infection.<br />
Rifampicin plus isoniazid plus pyrazinamide given daily <strong>for</strong> three months<br />
offered 49% protection. 886<br />
140<br />
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Figure 86. Mouse model of latent tuberculous infection <strong>and</strong> efficacy of various<br />
rifampicin combinations of preventive therapy on spleen bacillary count. Reproduced<br />
from 900 by the permission of the publisher American Thoracic Society at the American<br />
Lung Association.
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