Chemoprophylaxis of pulmonary tuberculosis. Current recommendations and controversies.

The recommendation for chemoprophylaxis for all persons under 21 years of age with a positive tuberculin reaction is accepted by nearly all authorities. Doubt exists concerning the treatment of those over 21 unless special risk factors are present. The key to safe isoniazid prophylaxis lies in emphasizing the side effects of hepatitis and in urging patients to report any untoward symptom. The alternative to prophylaxis must be close surveillance by means of periodic chest roentgenograms.