[Preventive antituberculosis chemotherapy in 250 patients of the antituberculosis outpatient clinic in Lausanne].

Between 1987 and 1990, 250 patients seen at the TB dispensary in Lausanne, Switzerland, received preventive antituberculous chemotherapy. All were tuberculin positive and had a further risk factor for the development of tuberculosis (recent contact with an infectious patient/recent conversion of the tuberculin test, fibrotic lesions on chest X-ray) or were young subjects who had recently immigrated from a country with high endemic tuberculosis. The group comprised 155 asylum seekers and refugees, 29 foreign workers, 24 foreign students and 42 Swiss citizens or long-term residents. 150 patients were detected by routine screening at entry into Switzerland, 33 by contact tracing, and 61 for other reasons. 165 were men (mean age 24 years) and 85 women (mean age 20.5 years). 191 subjects (76%) followed the prescribed isoniazid treatment for 6 months or more, 50 followed it for less than 6 months and 9 never started it. The treatment was interrupted 36 times due to lack of compliance, 4 times for medical reasons independent of the medication and 5 times due to pregnancy. 33 patients complained of side-effects (gastrointestinal in 20, cutaneous in 9, other in 4) which required interruption of treatment in 14. Liver enzymes were checked in 100 patients; significant elevation of the transaminases was observed in 3 patients who simultaneously complained of gastrointestinal side effects. In spite of practical problems, it seems possible to prescribe a full course of preventive antituberculous chemotherapy in the majority of patients where the treatment is indicated, and even in asymptomatic patients with whom communication is frequently difficult.(ABSTRACT TRUNCATED AT 250 WORDS)