Chemoprophylaxis of multidrug-resistant tuberculous infection in HIV-uninfected individuals using ciprofloxacin and pyrazinamide. A decision analysis.
OBJECTIVE
To evaluate the use of ciprofloxacin and pyrazinamide for the prophylaxis of individuals infected with multiply drug-resistant strains of Mycobacterium tuberculosis.


METHODS
Decision analysis, using software (SMLTREE). Probabilities based on published studies, with sensitivity analysis for each probability.


METHODS
Health-care workers infected with multidrug-resistant strains of M tuberculosis.


METHODS
Prophylaxis with ciprofloxacin and pyrazinamide.


RESULTS
We calculated the utilities of taking or not taking prophylaxis with ciprofloxacin and pyrazinamide. The decision analysis favored the use of ciprofloxacin-pyrazinamide prophylaxis by a small margin.


CONCLUSIONS
Ciprofloxacin-pyrazinamide prophylaxis should be considered for health-care workers infected with multiply drug-resistant M tuberculosis.
Stevens
J P
JP
Center for International Health, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
Daniel
T M
TM
D000328:Adult; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use*; D003661:Decision Support Techniques; D003663:Decision Trees; D018023:HIV Seronegativity; D006282:Health Personnel; D006801:Humans; D009784:Occupational Diseases / Q000382:microbiology / Q000517:prevention & control*; D011336:Probability; D011718:Pyrazinamide / Q000009:adverse effects / Q000627:therapeutic use*; D012680:Sensitivity and Specificity; D012984:Software; D018088:Tuberculosis, Multidrug-Resistant / Q000517:prevention & control*; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control*
D011718:Pyrazinamide; D002939:Ciprofloxacin