Acceptance of isoniazid preventive therapy by health care workers after tuberculin skin test conversion.
OBJECTIVE
To examine health care workers' (HCWs') acceptance of and adherence to isoniazid preventive therapy in the setting of a comprehensive tuberculin skin-testing program.


METHODS
Descriptive case series.


METHODS
University-affiliated inner-city public hospital in Atlanta, Ga.


METHODS
A total of 125 HCWs (91 hospital employees and 34 house staff or medical students [the physician group]) who had a positive tuberculin skin test between July 1992 and January 1994 and were offered isoniazid preventive therapy.


METHODS
Health care workers with a recent tuberculin skin test conversion were required to have a chest x-ray performed and see a physician and were encouraged but not required to undergo preventive therapy.


METHODS
Acceptance and initiation of preventive therapy with isoniazid by HCWs, completion of at least 6 months of preventive therapy, and differences between the employee and physician groups.


RESULTS
All 125 HCWs with a recent positive tuberculin skin test had a chest radiograph performed, 123 (98.4%) saw a physician, and 105 (84%) initiated preventive therapy. Sixty-nine (66%) of the 105off HCWs who initiated preventive therapy (55% of the 125 total) completed at least 6 months of isoniazid therapy. More of the physician group than of the employee group completed preventive therapy (25 of 34 [74%] vs 44 of 91 [48%], respectively; P<.01). Of the 36 HCWs who started but did not complete preventive therapy, 12 discontinued therapy because of an adverse drug effect and 24 were nonadherent.


CONCLUSIONS
Acceptance of tuberculosis preventive therapy by HCWs was high in the setting of a comprehensive tuberculin skin-testing program, and completion of therapy was much higher in the physician group than in previously reported series.
Camins
B C
BC
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30303, USA.
Bock
N
N
Watkins
D L
DL
Blumberg
H M
HM
D000328:Adult; D018890:Chemoprevention / Q000706:statistics & numerical data; D005260:Female; D005845:Georgia; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010349:Patient Compliance; D010564:Personnel, Hospital; D010820:Physicians; D014374:Tuberculin Test; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission
D007538:Isoniazid