Volume 12, Number 5—May 2006
Tuberculosis Special Section
Isoniazid Preventive Therapy and Risk for Resistant Tuberculosis
|Author, country, dates||Population||Intervention/comparison; blinding||Enrolled (n) INH/control||Follow-up; loss to follow-up; overall or INH vs. control||TB cases: culture positive/total (%)
||Definition of INH resistance||Resistant cases/total tested (% culture positive tested)
||Risk for resistant TB/1,000
|INH||Controls||INH||Controls||INH||Controls||RR (95% CI)|
|Ferebee, USA, 1957–NS (18)||Household contacts of TB patients||12 mo INH, 4–7 mg/kg/day/placebo; double blind||7,755/7,996||<10 y; 5.2% vs. 4.9% during Rx||NS/86||NS/215||>50 colonies growth in 0.2 μg/mL INH||2/10 NS||2/31 NS||2.22||1.73||1.28 (0.20–8.07)|
|Katz, USA, 1958–1964 (19)||Mental hospital patients with inactive lesions||2 y INH, 300 mg daily/no treatment; not blind||118/107||<4 y post-Rx; 30.6% overall†||NS/9||NS/10||Resistance to >0.25 γ INH||1/1 NS||2/5 NS||76.27||37.38||2.04 (0.52–8.08)|
|Horwitz, Greenland, 1956–1963 (20)||76 villages||2 × 13 wk INH, 400 mg twice weekly/0.1 mg INH; double blind||4,174/3,907||6 y; NS||123/238 (51.7)||186/323 (57.6)||(a) > 1 colony at >0.32 μg/mL INH||(a) 2/46||(a) 5/66||(a) 2.48||(a) 6.26||(a) 0.40 (0.08–1.97)|
|(b) Equal to control tube at >0.32 μg/mL INH||(b) 2/46 (37)||(b) 1/66 (36)||(b) 2.48||(b) 1.25||(b) 1.98 (0.18–21.31)|
|Comstock, USA (Alaska), 1957–1964 (21)||Residents of 28 villages and 2 boarding schools||12 mo INH, 300 mg§ daily/placebo; double blind||3,047/3,017||Med.: 69.3 mo (range 43–76 mo); 5.3% observed for <40 mo||NS/58||NS/141||NS||4/20 NS||1/50 NS||3.81||0.93||4.07 (0.47–34.98)|
|Ferebee, USA, 1960–1967 (9)||Persons with inactive lesions||12 mo INH, 5 m g/kg/day/placebo; NS||701/714||5 y; 2.2% by 1967||NS/18||NS/49||>50 colonies growth in 0.2 μg/mL INH||2/5 NS||2/25 NS||10.27||5.49||1.87 (0.31–11.19)|
|Pamra, India, 1958–1968 (22)||X-ray screening attendees with inactive TB||12 mo INH, 3–4 mg/kg/day/placebo; NS||139/178||<5 y post-Rx; 8.6% vs. 11.2%||10/18 (55.6)||57/76 (75)||Growth on 1 μg/mL INH||3/9 (90)||6/52 (91)||43.17||49.27||0.88 (0.24–3.15)|
|Hong Kong Chest Service, Hong Kong, 1981–1987 (27)||Men with silicosis||24 wk INH, 300 mg daily/placebo;double blind||167/159||2–5 y; 15.8% at 5 y||19/25 (76)||29/36 (80.6)||>20 colonies in >1 culture at >0.2 mg/L INH||5/19 (100)||4/28 (97)||39.39||32.35||1.22 (0.34–4.32)|
*INH, isoniazid; TB, tuberculosis; RR, relative risk; CI, confidence interval; NS, not stated; med., median; Rx, treatment.
†(a), definition of resistance as >1 colony growth at >0.32 μg/mL INH.
‡(b), definition of resistance as growth equal to control tube at >0.32 μg/mL INH.
§Children were given 5 mg/kg/day INH.
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1Current affiliation: Department of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile