Tuberculosis in the 1990's: resurgence, regimens, and resources.
Physicians in the United States must maintain vigilance for the 25,000 annual new cases of tuberculosis, concentrated in the elderly, in immigrants, in migrant and minority populations, and in immunosuppressed patients. Tuberculosis rates in the South remain above the national average. Physicians diagnosing tuberculosis may also treat the disease, working with health departments, which can assist with drugs, follow-up tests, and contact investigation. Powerful short-course regimens have been standard treatments since 1986. The preferred combination is isoniazid, rifampin, and pyrazinamide daily for 2 months, followed by isoniazid and rifampin for 4 more months. A 9-month regimen of isoniazid and rifampin is equally effective. Supplementation or extension of these regimens is mandatory when drug resistance or immunosuppression, respectively, is likely. Isoniazid prophylaxis for 6 to 12 months continues to be a vital but often neglected preventive measure for those infected with Mycobacterium tuberculosis, but without active disease.
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Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson 85724.
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D002648:Child; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D005188:False Negative Reactions; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D011718:Pyrazinamide / Q000627:therapeutic use; D013902:Radiography, Thoracic; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D013307:Streptomycin / Q000627:therapeutic use; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology
D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin