The effect of isoniazid prophylaxis on tuberculosis morbidity among household contacts of previously known cases of tuberculosis. Isoniazid prophylaxis among Alaskan Eskimos: a final report of the bethel isoniazid studies. Prophylaxis with isoniazid in inactive tuberculosis. A Veterans Administration Cooperative Study XII. A double-blind randomized controlled trial of primary isoniazid prophylaxis in dialysis and transplant patients. The IUAT trial on isoniazid preventive treatment in persons with fibrotic lung lesions. The use of isoniazid among household contacts of open cases of pulmonary tuberculosis. A CONTROLLED TRIAL OF ISONIAZID PROPHYLAXIS IN MENTAL INSTITUTIONS. Tuberculosis morbidity in a controlled trial of the prophylactic use of isoniazid among household contacts.
nan As a result of numerous trials, isoniazid prophylaxis was shown to be effective in preventing tuberculosis in many different populations and under a variety of conditions. However, the duration of the protective effect has been of some concern. In a previous report, the protective effect of isoniazid prophylaxis among Alaskan Eskimos was shown to persist through the fifteenth year after its administration. In this final report, the protective effect is shown to persist for more than 19 years. The magnitude of the effect is related to the amount of isoniazid taken. The results of the study are consistent with the hypothesis that the decrease in risk of tuberculosis produced by isoniazid preventive therapy is lifelong. Based on a study indicating a significant rate of reactivation of tuberculosis in Veterans Administration patients with inactive disease, a cooperative study was initiated to determine the prophylactic effect of isoniazid on the rate of reactivation. A randomized double-blind study was designed, utilizing three regimens, two with isoniazid and one with placebo only. Two consecutive years of taking pills in one of the three regimens was followed by five years of observation. A total of 7,036 patients with inactive disease, some of whom had received prior chemotherapy, were entered into the study. Only 63 reactivations of tuberculosis were found, for a total rate of reactivation of 9/1,000 (less than 1%) over the seven-year period. Although no significant differences in the rate of reactivation were found among any of the regimens, there was a significant reduction in the rate of reactivation among those who had not received any prior chemotherapy and received isoniazid (INH) in this study, compared with those who received placebo only. nan nan A controlled and double-blind study to determine the efficacy of isoniazid in preventing the development of pulmonary tuberculosis among the household contacts of open cases of the disease has been carried out in a rural area of Kenya-a financially handicapped country-under realistic field conditions.A one-year course of isoniazid (5-10 mg per kg of body-weight in one daily dose) administered to the contacts of active cases gave a reduction in respect of the excretion of tubercle bacilli of the order of 90% at the end of the year. In the subsequent observation period (2-4 years) both the control and the isoniazid-treated group showed a low and similar rate of adverse findings.Previous studies by the Tuberculosis Chemotherapy and BCG Centre, Nairobi, had revealed that the risk of tuberculosis among household contacts, especially children, was high and, further, that the acceptability of the drug and the regularity of drug-taking were poor among these contacts. Even so, a very considerable prophylactic effect of isoniazid was demonstrated in the present study. It therefore seems justifiable to conclude that the treatment of household contacts with isoniazid could contribute to tuberculosis control in financially handicapped countries, particularly where a tuberculosis case-finding programme is reasonably well established. nan nan
Isoniazid prevents active TB in diverse at-risk patients, and six- and 12-month regimens have a similar effect. The most recent trial included in the review was published in 1994, and we have not identified any relevant trials up to 2003. We therefore do not plan to update this review.