Title: PPD positive? Good news...
题目：结核菌素（PPD）试验阳性？好消息。。。
Author 作者: Emilie J. B. Calvello, MD, MPH

Background Information:
背景资料：
Active tuberculosis (TB) develops in 5-10% of individuals who become infected with M. tuberculosis, typically after a latency period of 6-18 months (but sometimes decades later).  Compliance with the 9 month self-supervised isoniazid (INH) regimen has been poor with completion rates <60%.  Until recently, daily rifampin for 4-6 months has been the only alternative when the bacterium is resistant or INH cannot be used.
5-10%有结核分枝杆菌感染的病人会发生活动性结核，通常在感染6－18个月以后（但有的时候会在几十年后）。自我监督下的9个月INH方案的完成率是不好的，大概在60％以下。一直到现在，4－6月的每日利福平是唯一的对INH抗药或不能用的病人的选择。
Pertinent Study Design and Conclusions:
相关的实验设计和结论：
Another rifamycin class antibiotic, Rifapentine (RPT) is approved for MDR-TB but had not been approved for latent TB treatment.
另外一个利福霉钠素类的抗菌素，利福喷丁（RPT）已被批准用于多药物耐药性的结核治疗，还不能用于潜伏期结核的治疗。

Recent RCTs show 12 weekly doses of INH-RPT administered as directly observed therapy (DOT) are efficacious in preventing active disease and are better tolerated.
最近临床试验结果显示，为期12周的INH-RPT在直接监督下服用非常有效地防止开放性疾病的产生，病人的耐受性又好。

CDC now recommends the 12 week INH-RPT DOT regimen as an equal alternative to 9 months of self supervised daily INH in patients aged >12 years who have a high likelihood of developing active TB.
美国疾病控制中心现在建议对并极有发展成开放性结核的12岁以上的病人可以用直接监视下的12周INH-RPT的方案来替代自行监督的9个月的INH方案。

Bottom LIne:
要点：
A substantially shorter course of therapy with INH-RPT is now the recommended treatment for latent TB.
相当短疗程的INH－RPT现在可以用来治疗潜伏期的结核。

References 参考文献
CDC. Recommendations for use of an isoniazid-rifapentine regimen with direct observation to treat latent Mycobacterium tuberculosis infection. MMWR Morb Mortal Wkly Rep, 2011 Dec 9;60(48):1650-1653.