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Published on: October 25, 2024
Rifapentine-based treatment of tuberculosis infection in Spanish adolescents
Antoni Noguera-Julian1, Cristina Latre2, Montserrat Ruiz3
1Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses i Patologia Importada, Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain; Red de Investigación Traslacional en Infectología Pediátrica RITIP, Madrid, Spain.
Introduction:
Tuberculosis infection (TBI) in adolescents carries a high risk of progression to tuberculosis disease, yet treatment adherence remains a challenge.
Methods:
Case series description.
Results:
We describe a real-world experience of implementing a 12-dose weekly regimen of isoniazid (INH) and rifapentine (RPT) under video-observed therapy (VOT) in four adolescent diagnosed with TBI in a contact tracing study. This approach was chosen due to logistical and adherence concerns that made daily regimens and directly observed therapy (DOT) unfeasible. RPT was requested as a foreign medication and approved within three weeks. All patients completed treatment with 100% adherence and good tolerance.
Conclusions:
Our experience supports the feasibility, tolerability, and high adherence of VOT-based weekly INH-RPT regimens in adolescents, despite regulatory barriers limiting RPT access in Europe. Broader availability of RPT and innovative adherence strategies like VOT are urgently needed to optimize TB preventive treatment in this age group. .
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