High-dose rifampicin to treat tuberculosis infection: potential and pitfalls

Scaling up effective, safe, short-course regimens to treat tuberculosis infection remains an important, but unmet priority to reduce the global burden of tuberculosis, which caused 10·6 million illnesses and 1·3 million deaths in 2022.1 A randomised controlled trial published in The Lancet Respiratory Medicine by Rovina Ruslami and colleagues is the first to evaluate 2 months of high-dose rifampicin as a potential tuberculosis preventive treatment (TPT) regimen.2 Rifampicin is a key drug in the treatment of tuberculosis infection and tuberculosis disease.