Medication Duration Interval Comments Isoniazid & 3 Once per week; Treatment for individuals: Rifapentine months* direct >12 years of age observation Not recommended for individuals INH 15 mg/kg therapy (DOT) who are: (max 900 mg) -pregnant or expect to become & pregnant within 12 RPT -living with HIV infection >50 kg-900 mg -presumed infected with INH or (max 900 mg) RIF-resistant TB Isoniazid 9 Daily Preferred treatment for individuals: INH 5 mg/kg months** -living with HIV infection*** (max 300 mg) -pregnant (with pyridoxine/vitamin B6 supplements)**** Isoniazid 9 months Twice weekly Preferred treatment for individuals if: INH 15 mg/kg (DOT) -pregnant (with pyridoxine/vitamin (max 900 mg) B6 supplements) -concern for poor adherence Rifampin 4 months Daily Only used if individual cannot RIF 10 mg/kg tolerate INH or known exposure to (max 600 mg) INH resistant TB *Given ease of DOT in Job Corps setting and shorter duration of treatment, this will likely be the preferred option for centers; the 12 dose, once weekly, directly observed regimen is equivalent to the 9 month INH daily regimen **9 months of INH treatment is preferred to 6 months; however, 6 months may be more cost effective and result in greater adherence; every effort should be made to ensure at minimum 6 months completed ***HIV infected individuals on ART may be treated for 9 months; if not on ART, consideration for 12 months treatment recommended ****In pregnancy, consider delaying treatment until after delivery unless high risk for progression to active disease (recent TB exposure, HIV infected) Educate students potential side effects and the need to notify a health provider immediately if experiencing nausea, vomiting, abdominal pain, loss of appetite, yellow skin or eyes, dark urine, fever, rash, numbness of hands or feet. Pyridoxine (vitamin B6) supplements need not be given with isoniazid in otherwise healthy youth, unless pregnant. Baseline liver function testing is not routinely necessary in healthy students with no history of liver disease and taking no medications that may alter liver function. Testing is recommended at baseline for students with liver disease, HIV infection, regular alcohol use, and pregnancy. It can be considered for students taking chronic medications that may alter liver function.
Medication Duration Interval Comments Isoniazid & Rifapentine INH 15 mg/kg (max 900 mg) & RPT >50 kg-900 mg (max 900 mg) 3 months* Once per week; direct observation therapy (DOT) Treatment for individuals: >12 years of age Not recommended for individuals who are: -pregnant or expect to become pregnant within 12 -living with HIV infection -presumed infected with INH or RIF-resistant TB Isoniazid INH 5 mg/kg (max 300 mg) 9 months** Daily Preferred treatment for individuals: -living with HIV infection*** -pregnant (with pyridoxine/vitamin B6 supplements)**** Isoniazid INH 15 mg/kg (max 900 mg) 9 months Twice weekly (DOT) Preferred treatment for individuals if: -pregnant (with pyridoxine/vitamin B6 supplements) -concern for poor adherence Rifampin RIF 10 mg/kg (max 600 mg) 4 months Daily Only used if individual cannot tolerate INH or known exposure to INH resistant TB *Given ease of DOT in Job Corps setting and shorter duration of treatment, this will likely be the preferred option for centers; the 12 dose, once weekly, directly observed regimen is equivalent to the 9 month INH daily regimen **9 months of INH treatment is preferred to 6 months; however, 6 months may be more cost effective and result in greater adherence; every effort should be made to ensure at minimum 6 months completed ***HIV infected individuals on ART may be treated for 9 months; if not on ART, consideration for 12 months treatment recommended ****In pregnancy, consider delaying treatment until after delivery unless high risk for progression to active disease (recent TB exposure, HIV infected) Educate students potential side effects and the need to notify a health provider immediately if experiencing nausea, vomiting, abdominal pain, loss of appetite, yellow skin or eyes, dark urine, fever, rash, numbness of hands or feet. Pyridoxine (vitamin B6) supplements need not be given with isoniazid in otherwise healthy youth, unless pregnant. Baseline liver function testing is not routinely necessary in healthy students with no history of liver disease and taking no medications that may alter liver function. Testing is recommended at baseline for students with liver disease, HIV infection, regular alcohol use, and pregnancy. It can be considered for students taking chronic medications that may alter liver function.
TG_tuberculin.docx