10 A？os innovando en el tratamiento de la infección tuberculosa latente: comparación entre pautas estándar y pautas cortas en tratamiento directamente observado

objectives: the main aim of the study is to compare the acceptance, adherence, tolerance and safety of short course therapies in comparison to a standard 9 month treatment for latent tuberculosis infection (ltbi) in directly observed therapy (dot) and contrast this with previous results from a standard therapy in patient self-administered treatment. materials and methods: retrospective longitudinal study carried out at a medium sized prison. period of inclusion covers 10 years, from january 2000 to december 2009. the centers for disease control and prevention (cdc) inclusion and exclusion criteria were used, as well as the ones included in the program for tuberculosis prevention and control in the prison environment. 4 ltbi therapies according to the preference of the patient and possible interactions with other treatments were utilised. therapy i consisted of isoniazid (h) in doses of 300 mg/day for 9 months (9h), therapy ii with rifampicin for 2 months, twice a week, (2r2z2) therapy iii with rifampicin and isoniazid for 3 months (3rh) and therapy iv with rifampicin for four months (4r). treatment was administered under strict dot conditions by nursing staff. results: 902 patients were included, of which 810 accepted the treatment (89.90%), distributed as follows: 400 in the 9h therapy, and 410 with short course therapies (316 in the 2r2z2, 82 in the 3rh therapy and 12 in the 4r therapy). 92 patients (10.20%) did not accept ltbi therapy, 271 patients (67.75%) concluded the ltbi treatment with 9h, and 314 (76.60%) with short courses. 232 patients (73.42%) concluded the 2r2z2, 85.40% with the 3rh 70 therapy and 12 (100%) with the 4r treatment. 129 patients (32.25%) did not complete the ltbi 9h therapy (63 due to voluntary withdrawal, 35 due to adverse reactions, 26 for release or transfer, 2 for unknown reasons, 1 due to tuberculosis in a hiv-patient and 1 due to suicide). 96 patients (23.41%) did not conclude the short course therapies (36 due to voluntary withdrawa