USA, Canada. The American Thoracic Society and the Centers for Disease Control and Prevention (CDC) recommend that the combined regimen of pyrazinamide and rifampicin should not be offered as a first-line treatment to persons with latent tuberculosis infection (LTBI). This advice follows a recent CDC report describing high rates of hospitalisation and death from liver injury following the combined use of these two drugs in LTBI patients¹. The CDC advises the use of alternative recommended regimens in LTBI. Health Canada has made a similar announcement, based on the CDC findings and directives². Health Canada advises that recommendations for the treatment of active TB remain unchanged³.

Reference:

1. MMWR 52(31): 735-739, 8 August 2003. Available from URL: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a4.htm

2. ‘Dear Healthcare Professional’ letter from Pharmascience Inc and ICN Canada Limited, 12 December 2003. Available from URL: http://www.hc-sc.gc.ca

3. http://www.hc-sc.gc.ca/pphb-dgspsp/tbpc-latb/pubse.html