Substitution of rifapentine for rifampin during intensive phase treatment of pulmonary tuberculosis: study 29 of the tuberculosis trials consortium.

BACKGROUND: Rifapentine administered 5 days per week has potent activity in mouse models of antituberculosis chemotherapy, but efficacy and safety data are limited in humans. We compared the antimicrobial activity and safety of rifapentine vs rifampin during the first 8 weeks of pulmonary tuberculosis treatment. METHODS: In total, 531 adults with sputum smear-positive pulmonary tuberculosis were randomized to rifapentine 10 mg/kg/dose or rifampin 10 mg/kg/dose, administered 5 days per week for 8 weeks (intensive phase), with isoniazid, pyrazinamide, and ethambutol. Coprimary outcomes were negative sputum culture on liquid and on solid media at completion of intensive phase. RESULTS: Negative cultures on solid media occurred in 145 of 174 participants (83.3%) in the rifampin group and 171 of 198 participants (86.4%) in the rifapentine group (difference, 3.0%; 95% confidence interval [CI]: -4.3, 10.5); negative cultures in liquid media occurred in 110 of 169 (65.1%) in the rifampin group and 133 of 196 (67.9%) in the rifapentine group (difference, 2.8%; 95% CI: -6.9, 12.4). Among 529 participants who received study therapy, 40 of 254 participants (15.7%) in the rifampin group and 40 of 275 participants (14.5%) in the rifapentine group prematurely discontinued treatment (P=.79). CONCLUSIONS: The rifapentine regimen was safe but not significantly more active than a standard rifampin regimen, by the surrogate endpoint of culture status at completion of intensive phase. Assessment of higher exposures to rifapentine for tuberculosis treatment is warranted. CLINICAL TRIALS REGISTRATION: NCT00694629.

Long-term performance of aged waste forms treated by stabilization/solidification.

Current regulatory testing of stabilized/solidified (S/S) soils is based on short-term performance tests and is insufficient to determine their long-term stability or expected service life. In view of this, and the significant lack of data on long-term field performance in the literature, S/S material has been extracted from full-scale remedial operations and examined using a variety of analytical techniques to evaluate field performance. The results, including those from X-ray analytical techniques, optical and electron microscopy and leaching tests are presented and discussed. The microstructure of retrieved samples was found to be analogous to other cement-based materials, but varied according to the soil type, the contaminants present, the treatment applied and the field exposure conditions. Summary of the key microstructural features in the USA and UK is presented in this work. The work has shown that during 16 years of service the S/S wastes investigated performed satisfactorily.