TUBERCULOSIS CHEMOPROPHYLAXIS PRACTICES IN METROPOLITAN CLINICS

Abstract

A survey of tuberculosis chemoprophylaxis policies was conducted from Sept. 1977 through Jan. 1978 of all metropolitan programs in the USA that reported more than 100 cases of tuberculosis during 1976. Twenty-eight programs were surveyed, and all responded. Uniform practice was found with regard to the dosage of isoniazid administered, duration of treatment, and most other indications for preventive therapy recommended by the American Thoracic Society and the U.S. Public Health Service Center for Disease Control. One third of the programs surveyed administered chemoprophylaxis to pregnant women, and 1/3 regularly dispensed more than a 1 mo. supply of isoniazid to patients. Three programs (11%) routinely monitored hepatic function by serum laboratory tests during chemoprophylaxis. Four programs (14%) regularly or occasionally used BCG vaccine for prevention of tuberculosis. Although large metropolitan programs generally followed the guidelines of the American Thoracic Society and the Center for Disease Control for tuberculosis chemoprophylaxis, some major variances in practice were reported.