Monitored Isoniazid Prophylaxis for Low-Risk Tuberculin Reactors
Authors: Shelley R. Salpeter
Journal: Annals of Internal Medicine (1998)

Letters15 June 1998Monitored Isoniazid Prophylaxis for Low-Risk Tuberculin ReactorsShelley R. Salpeter, MD, Gillian D. Sanders, AB, and Douglas K. Owens, MD, MScShelley R. Salpeter, MDSanta Clara Valley Medical Center; San Jose, CA 95128Stanford University; Stanford, CA 94305Veterans Affairs Palo Alto Health Care System; Palo Alto, CA 94304Search for more papers by this author, Gillian D. Sanders, ABSanta Clara Valley Medical Center; San Jose, CA 95128Stanford University; Stanford, CA 94305Veterans Affairs Palo Alto Health Care System; Palo Alto, CA 94304Search for more papers by this author, and Douglas K. Owens, MD, MScSanta Clara Valley Medical Center; San Jose, CA 95128Stanford University; Stanford, CA 94305Veterans Affairs Palo Alto Health Care System; Palo Alto, CA 94304Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-12_Part_1-199806150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Moulding for his comments. We concluded that isoniazid prophylaxis modestly extends life expectancy for treated patients and would prevent 35 176 deaths if the entire population of low-risk tuberculin reactors older than 35 years of age received prophylaxis. Tsevat and colleagues' analysis [1], performed a decade ago, concluded that the use of isoniazid was a “close call” for an individual patient and decreased life expectancy by a few days per treated patient. One important difference between the two analyses is that we used estimates of the fatality rate with monitored isoniazid prophylaxis that were based ...References1. Tsevat J, Taylor WC, Wong JB, Pauker SG. Isoniazid for the tuberculin reactor: take it or leave it. Am Rev Respir Dis. 1988; 137:215-20. Google Scholar2. Salpeter E, Salpeter S. A mathematical model for the epidemiology of tuberculosis, with estimates of the infectivity factor and infection delay function. Am J Epidemiol. 1998; 141:398-406. Google Scholar3. Efficacy of various durations of isoniazid preventive therapy for tuberculosis: five years of follow-up in the IUAT trial. International Union Against Tuberculosis-Committee on Prophylaxis. Bull WHO. 1982; 60:555-64. Google Scholar4. MacKay AD, Cole RB. The problems of tuberculosis in the elderly. Q J Med. 1984; LIII:497-510. Google Scholar Author, Article, and Disclosure InformationAuthors: Shelley R. Salpeter, MD; Gillian D. Sanders, AB; Douglas K. Owens, MD, MScAffiliations: Santa Clara Valley Medical Center; San Jose, CA 95128Stanford University; Stanford, CA 94305Veterans Affairs Palo Alto Health Care System; Palo Alto, CA 94304 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1998Volume 128, Issue 12_Part_1Page: 1048KeywordsDeath ratesDiagnostic radiologyDrug abuseEmotionsHIV infectionsIsoniazidLife expectancyProphylaxisThoraxTuberculin ePublished: 15 August 2000 Issue Published: 15 June 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...