Table 2.

TB preventive treatment regimens

Regimen	Dosea	Comments
4 mo of daily rifampicin	Age 10 y and older: 10 mg/kg/d Age <10 y: 15 mg/kg/d (range, 10–20 mg)	• Less hepatotoxicity than isoniazid monotherapy: 1.8% for 6H vs. 03% for 4R [64], • Less than 0.01 difference in confirmed tuberculosis when comparing rifampin and isoniazid after 28 mo of follow-up [66]. • Potent inducer of the cytochrome P450 enzyme system and can reduce concentrations of certain drugs (e.g. warfarin and protease inhibitors) significantly.b
3 mo of daily rifampicin plus isoniazid	Isoniazid: Age 10 y and older: 5 mg/kg/d Age <10 y: 10 mg/kg/d (range, 7–15 mg) Rifampicin: Age 10 y and older: 10 mg/kg/d Age <10 y: 15 mg/kg/d (range, 10–20 mg)	• Hepatotoxic risk not significantly different from 6H (OR 0.83, 95% Cl, 0.49–1.42) [59]. • Paediatric fixed dose formulations available; might be the preferred option in young children. • Potent inducer of the cytochrome P450 enzyme system and can reduce concentrations of certain drugs significantly (e.g. warfarin and protease inhibitors).b
3 mo weekly rifapentine plus isoniazid (12 doses)	Age 2–14 y: Differ by weight band (see the WHO guidelines3) Age >14 y: Rifapentine 900 mg + Isoniazid 900 mg	• Less hepatotoxicity than isoniazid monotherapy: 1.5% for 3HP vs. 5.5% for 6H (in HIV-positive)2 and 0.4% for 3HP vs. 2.7% for 9H (in HIV-negative) [65]. • There was a difference of 24% in TB occurrence in the 3HP group versus the isoniazid group [63]. • Systemic drug reactions appear to be more common than others: 3.5% for 3HP vs. 0.4% for 9H [60]. • Limited data in pregnant women and children <2 y. • Potent inducer of the cytochrome P450 enzyme system and can reduce concentrations of certain drugs significantly (e.g. warfarin and protease inhibitors).b
1 mo of daily rifapentinec plus isoniazid (28 doses)	Age ≤13 y (regardless of weight band) Isoniazid, 300 mg/d Rifapentine, 600 mg/d	• Hepatotoxicity less or similar to 9H: 2% for 1HP vs. 3% for 9H [62], • No hypersensitivity reactions in 1496 participants in one RCT [62], • There were 2% of TB cases in both isoniazid and 1HP group after 33 y [57], • Limited evidence in children <13 y. One prospective cohort study (n = 408) reported its' safety in 2–19 y [61]. • Potent inducer of the cytochrome P450 enzyme system and can reduce concentrations of certain drugs significantly (e.g. warfarin and protease inhibitors).b
6 or 9 mo of daily isoniazid	Age 10 y and older: 5 mg/kg/d Age <10 y: 10 mg/kg/d (range, 7 –15 mg)	• Less preferred to rifamycin-containing regimens.
6 mo of daily levofloxacin	Age >14 y, by body weight: <46 kg, 750 mg/d; >45 kg, 1g/d Age <15 y (range, approx. 15 –20 mg/kg/d), by body weight: • 5–9 kg: 150 mg/d; • 10–15 kg: 200–300 mg/d; • 16–23 kg: 300–400 mg/d; • 24–34 kg: 500–750 mg/d.	• Regimens should be developed for other types of drug resistance.

1HP, 1 mo of daily rifapentine plus isoniazid; 3HP, 3 mo weekly rifapentine plus isoniazid; 4R, 4 mo of daily rifampicin; 6H, 6 mo of daily isoniazid; 9H, 9 mo of daily isoniazid.

^aBased on WHO consolidated guidelines on tuberculosis. Module 1: prevention—tuberculosis preventive treatment.

^bDetailed information is available elsewhere (e.g. https://reference.medscape.com/drug-interactionchecker).

^cRifapentine is not currently available in many European countries [68].