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Treatment Regimens for Latent TB Infection (LTBI)

The four treatment regimens for latent TB infection (LTBI) use isoniazid (INH), rifapentine (RPT), or rifampin (RIF). While all the regimens are effective, healthcare providers should prescribe the more convenient shorter regimens, when possible. Patients are more likely to complete shorter treatment regimens.

Treatment must be modified if the patient is a contact of an individual with drug-resistant TB disease. Consultation with a TB expert is advised if the known source of TB infection has drug-resistant TB.

CDC has updated the recommendations for use of once-weekly isoniazid-rifapentine for 12 weeks (3HP) for treatment of latent TB infection.

Latent TB Infection Treatment Regimens

Drug(s) Duration Dose Frequency Total Doses
Isoniazid (INH)* and Rifapentine (RPT) 3 months Adults and Children aged 12 years and older:
INH: 15 mg/kg rounded up to the nearest 50 or 100 mg; 900 mg maximum
RPT:
10–14.0 kg 300 mg
14.1–25.0 kg 450 mg
25.1–32.0 kg 600 mg
32.1–49.9 kg 750 mg
≥50.0 kg 900 mg maximum
Children aged 211 years:
INH*: 25 mg/kg; 900 mg maximum
RPT: as above
Once weekly 12
Rifampin (RIF)§ 4 months Adult: 10 mg/kg

Children: 15–20 mg/kg
Maximum dose: 600 mg

Daily 120
Isoniazid (INH) 9 months Adult: 5 mg/kg
Children: 10–20 mg/kg
Maximum dose: 300 mg
Daily 270
Adult:15 mg/kg

Children: 20–40 mg/kg

Maximum dose: 900 mg

Twice weekly 76
6 months Adult: 5 mg/kg

Children: Not recommended

Maximum dose: 300 mg

Daily 180
Adult: 15 mg/kg

Children: Not recommended

Maximum dose: 900 mg

Twice weekly 52

*Isoniazid (INH) is formulated as 100 mg and 300 mg tablets.
Rifapentine (RPT) is formulated as 150 mg tablets in blister packs that should be kept sealed until use.
Intermittent regimens must be provided via directly observed therapy (DOT), that is, a health care worker observes the ingestion of medication.
§Rifampin (rifampicin; RIF) is formulated as 150 mg and 300 mg capsules.
The American Academy of Pediatrics acknowledges that some experts use RIF at 20–30 mg/kg for the daily regimen when prescribing for infants and toddlers (American Academy of Pediatrics. Tuberculosis. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st ed. Itasca, IL: American Academy of Pediatrics; 2018:829–853).
The American Academy of Pediatrics recommends an INH dosage of 10–15 mg/kg for the daily regimen and 20–30 mg/kg for the twice weekly regimen.

*, †, ‡, §, ‖, ¶ [standard sequence of footnote symbols, for reference during revisions]

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