Jenkins D, Davidson F F
Calif Med. 1972 Apr;116(4):1-5.
A major step toward the eradication of tuberculosis in the United States has been the use of isoniazid for chemoprophylaxis in certain persons who have positive tuberculin skin tests but no other evidence of active infection. Chemical trials have demonstrated the effectiveness of chemoprophylaxis in groups where there is a relatively high risk of active tuberculosis. However, only the practicing physician can identify and offer chemoprophylaxis to many other susceptible persons. Even if the patient is a candidate for isoniazid, the risk of developing tuberculosis must be weighed against the cost and possible adverse effects of the drug. If isoniazid is given, the physician must be alert to the signs of possible drug toxicity. If isoniazid is not given, he must anticipate the development of active tuberculosis in susceptible persons.
在美国,朝着根除结核病迈出的重要一步是在某些结核菌素皮肤试验呈阳性但无其他活动性感染证据的人群中使用异烟肼进行化学预防。化学试验已证明在活动性结核病风险相对较高的人群中化学预防的有效性。然而,只有执业医师才能识别并为许多其他易感人群提供化学预防。即使患者适合使用异烟肼,也必须权衡患结核病的风险与药物的成本及可能的不良反应。如果使用异烟肼,医师必须警惕可能的药物毒性迹象。如果不使用异烟肼,他必须预料到易感人群中活动性结核病的发生。