- ATLANTA (Reuters) - U.S.
health officials on Thursday warned doctors to limit their use of a promising
drug cocktail when treating cases of latent tuberculosis because the therapy
caused severe liver injuries and death in some patients.
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- The Centers for Disease Control and Prevention and the
American Thoracic Society issued the advisory after a CDC investigation
revealed that at least six people with latent TB had died since 1999 after
being prescribed a two-month course of the antibiotics rifampin and pyrazinamide.
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- Another 17 people were hospitalized with hepatitis or
other liver injuries after taking the drugs, which are used to treat both
the latent asymptomatic form of TB as well as the potentially fatal active
strain of the lung disease.
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- An estimated 10 million to 15 million Americans are infected
with latent TB, which is caused by an airborne bacteria spread through
coughing or other close contact with infected persons.
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- Antibiotics cure most cases of TB.
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- The CDC said a nine-month course of isoniazid was the
preferred treatment for latent TB, especially in cases where patients suffered
from alcoholism or were taking other medications linked to liver problems.
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- The discovery of serious side-effects linked to the two-month
course of rifampin-pyrazinamide in latent TB patients came as a small blow
to health officials battling to control the disease.
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- Doctors had hoped that the shorter course would improve
the success rate when treating TB patients.
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- ``You could consider it a setback in that a promising
short-course regimen is not likely to be used as commonly as we had hoped
to,'' said Dr. Kenneth Castro, director of the CDC's TB elimination program.
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- But Castro noted that rifampin-pyrazinamide remained
an option for treating active TB, those at high risk of developing active
TB and patients who were unlikely to be able to complete a nine-month course
of isoniazid.
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- Intravenous drug users, prison inmates and individuals
infected with HIV, are among those considered at high risk of TB infection.
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- The number of active TB cases in the United States declined
to a record low of 16,377 last year due to improved screening and treatment.
TB had made a remarkable comeback in the 1980s in step with the emergence
of AIDS.
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