Isoniazid Preventive Therapy

Abstract

In 1972, an unusual number of hepatitis deaths associated with isoniazid preventive therapy occurred in Baltimore, both among patients enrolled in a U.S. Public Health Service study of isoniazid-associated hepatitis and among other patients who were given isoniazid to prevent tuberculosis. The present study examined the impact of the reactions of the medical world to these deaths, as reflected by the types of patients subsequently given preventive treatment and the apparent effectiveness of increased care in monitoring symptoms on the frequency and severity of hepatitis. The analysis is based on the experience of 5,300 patients, all of whom were reported to have been placed on preventive treatment with isoniazid in 15 Maryland county health departments, from January 1973 through June 1977. During this period, the number of patients increased from 665 in 1973 to 1,544 in 1976. There was little change in the race-sex composition or in the proportion of contacts, although the mean age of the patients decreas...