Table 14.18-6. Treatment regimens for LTBI recommended by the World Health Organization

Drug(s)

Duration

Schedule

Mode of administration

Level of evidencea

INH

6-9 monthsb

Daily

SAP

1

INH/RMP

3-4 months

Daily

SAP

1

INH/RPTc

3 months

Once weekly

DOP

1

RMP

3-4 monthsd

Daily

SAP

2

a Level 1, multiple randomized trials. Level 2, single randomized trial and/or multiple observational (cohort) studies.

b Canadian guidelines suggest 9 months as standard and 6 months as an acceptable alternative.

c Use this regimen with careful monitoring for hypersensitivity reactions, as these can be severe. RPT is only available in Canada through the Special Access Program.

d The Canadian standard is 4 months.

Based on: Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization; 2018 and Canadian Tuberculosis Standards, 7th Edition. The Public Health Agency of Canada, The Lung Association, and the Canadian Thoracic Society, 2014.

DOP, directly observed prophylaxis; INH, isoniazid; LTBI, latent tuberculosis infection; RMP, rifampin (international nonproprietary name: rifampicin); RPT, rifapentine; SAP, self-administered prophylaxis.