CDC Releases Interim Guidance on a Four-Month TB Treatment Regimen

At a glance

The letter announces the release of interim guidance for a 4-month treatment regimen to treat drug-susceptible TB disease.

Dear Colleague Letters

February 24, 2022

Dear Colleagues,

Today, the U.S. Centers for Disease Control and Prevention (CDC) released new interim guidance for a 4-month treatment regimen to treat drug-susceptible TB disease that is as effective as the standard 6-month regimen for TB treatment. The new 4-month rifapentine-moxifloxacin regimen is a daily treatment option for people 12 years of age and older with drug-susceptible pulmonary TB disease in the United States.

Shorter treatment regimens for TB disease can be more convenient and help patients finish treatment faster. The 4-month rifapentine-moxifloxacin regimen has an intensive phase of 8 weeks of daily treatment with rifapentine, isoniazid, pyrazinamide, and moxifloxacin followed by a continuation phase of 9 weeks of daily treatment with rifapentine, isoniazid, and moxifloxacin (a total of 17 weeks for treatment).

The guidance is based on results from an international phase 3 clinical trial sponsored by CDC's Tuberculosis Trials Consortium and conducted in collaboration with the National Institutes of Health-sponsored AIDS Clinical Trials Group. This was the first successful short treatment regimen for drug-susceptible TB disease identified in almost 40 years. I would like to congratulate the authors of this important study for recently being recognized as one of the New England Journal of Medicine's (NEJM) 2021 Notable Articles. The "Notable Articles" are selected by NEJM editors as the most meaningful in changing medical practice and improving patient care.

CDC has resources on the 4-month rifapentine-moxifloxacin regimen for healthcare providers and TB programs, including

  • An updated Treatment of TB Disease webpage that includes a regimen table, considerations for specific groups of people with TB disease, and a comparison table of TB disease treatment regimens,
  • A checklist to ensure the correct timing of testing and monitoring for patients through the regimen, and
  • A Frequently Asked Questions (FAQ) webpage to address common questions about a new 4-month regimen.

Healthcare providers can contact their State TB Control Offices and the TB Centers of Excellence for Training, Education, and Medical Consultation for additional information about the new treatment regimen and support in treating people with TB disease.

Sincerely,

Philip LoBue, MD, FACP, FCCP
Director
Division of Tuberculosis Elimination
National Center for HIV, Viral Hepatitis, STD, and TB Prevention