{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T09:02:10Z","timestamp":1759482130221,"version":"3.40.5"},"reference-count":50,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,3,1]]},"abstract":"<jats:p>BACKGROUND. Guidelines for latent tuberculosis infection do not consider drug-resistance patterns when recommending treatment for immigrant children.<\/jats:p><jats:p>OBJECTIVES. The purpose of this research was to decide at what rate of isoniazid resistance a different regimen other than isoniazid for 9 months should be considered.<\/jats:p><jats:p>METHODS. We constructed a decision tree by using published data. We studied 3 regimens considered to be effective for susceptible organisms: (1) isoniazid for 9 months, (2) rifampin for 6 months, and (3) isoniazid for 9 months plus rifampin for 6 months. In addition, we evaluated a regimen of isoniazid and rifampin for 3 months. Our base case was a 2-year-old child from Russia with a tuberculin skin test reaction of 12 mm. We assumed a societal perspective and expressed results as cost and cost per case of tuberculosis prevented. We conducted sensitivity analyses to test the stability of our model.<\/jats:p><jats:p>RESULTS. In our baseline analysis, rifampin was the least costly treatment regimen for any child arriving from an area with an isoniazid-resistance rate of \u226511%. Treatment with isoniazid plus rifampin was the most effective but would cost more than $1 million per reactivation case prevented. Isoniazid would become the least costly regimen if any of the following thresholds were met: rifampin resistance given isoniazid resistance of more than 82%; rifampin resistance given no isoniazid resistance of &amp;gt;9%; cost of rifampin more than $47\/month; effectiveness of rifampin lower than 63%; effectiveness of isoniazid higher than 74%; and cost of pulmonary tuberculosis less than $7661. Isoniazid and rifampin for 3 months was the least costly for all cases from areas with isoniazid resistance of &amp;lt;80% as long as the regimen's effectiveness was &amp;gt;50% for susceptible bacteria. However, this assumption remains to be proven.<\/jats:p><jats:p>CONCLUSION. Because of the high prevalence of isoniazid resistance, rifampin should be considered for children with latent tuberculosis infection originating from countries with &amp;gt;11% isoniazid resistance.<\/jats:p>","DOI":"10.1542\/peds.2008-0433","type":"journal-article","created":{"date-parts":[[2009,3,2]],"date-time":"2009-03-02T12:49:02Z","timestamp":1235998142000},"page":"816-822","source":"Crossref","is-referenced-by-count":12,"title":["Latent Tuberculosis Infection in Children: A Call for Revised Treatment Guidelines"],"prefix":"10.1542","volume":"123","author":[{"given":"S. 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