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rifapentine + isoniazid is a combination antibiotic therapy primarily utilized for the treatment of latent tuberculosis infection (LTBI). This regimen, frequently referred to as the 3HP regimen, consists of weekly doses of rifapentine and high-dose isoniazid for a duration of three months (12 doses). Rifapentine, a rifamycin derivative, exerts its antibacterial effect by inhibiting DNA-dependent RNA polymerase, thereby blocking bacterial RNA synthesis. Isoniazid is a prodrug that, upon activation by the mycobacterial catalase-peroxidase enzyme KatG, inhibits the synthesis of mycolic acids by targeting enoyl-[acyl-carrier-protein] reductase [NADH] (InhA), which is essential for the Mycobacterium tuberculosis cell wall. The National Taiwan University Hospital is investigating this combination in a multicenter randomized controlled trial in Taiwan to evaluate its treatment completion rate and safety profile compared to the standard nine-month daily isoniazid monotherapy. The shorter duration and weekly dosing schedule of the 3HP regimen are intended to enhance patient compliance and treatment success in high-endemic areas.
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