Isoniazid preventive therapy and risk for resistant tuberculosis.


Balcells, ME; Thomas, SL; Godfrey-Faussett, P; Grant, AD; (2006) Isoniazid preventive therapy and risk for resistant tuberculosis. Emerging infectious diseases, 12 (5). pp. 744-51. ISSN 1080-6040 DOI: 10.3201/eid1205.050681

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Abstract

: In the context of tuberculosis (TB) resurgence, isoniazid preventive therapy (IPT) is increasingly promoted, but concerns about the risk for development of isoniazid-resistant tuberculosis may hinder its widespread implementation. We conducted a systematic review of data published since 1951 to assess the effect of primary IPT on the risk for isoniazid-resistant TB. Different definitions of isoniazid resistance were used, which affected summary effect estimates; we report the most consistent results. When all 13 studies (N = 18,095 persons in isoniazid groups and N = 17,985 persons in control groups) were combined, the summary relative risk for resistance was 1.45 (95% confidence interval 0.85-2.47). Results were similar when studies of HIV-uninfected and HIV-infected persons were considered separately. Analyses were limited by small numbers and incomplete testing of isolates, but findings do not exclude an increased risk for isoniazid-resistant TB after IPT. The diagnosis of active TB should be excluded before IPT. Continued surveillance for isoniazid resistance is essential.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Antimicrobial Resistance Centre (AMR)
TB Centre
PubMed ID: 16704830
Web of Science ID: 237187200005
URI: http://researchonline.lshtm.ac.uk/id/eprint/11397

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