[Measures for tuberculosis in compromised hosts--mainly on chemoprophylaxis].
As for the measures for tuberculosis in Japan, BCG inoculation and chemoprophylaxis have been done with emphasis placed on children and young people. Since, however, about 90% are older than 30 years and more than 50% are older than 60 years among the new TB patients, measures, particularly chemoprophylaxis aiming at the middle-old aged people are needed in the future. We discuss the method to select cases for chemoprophylaxis as to the cases of diabetes, collagen diseases and lung cancer administered corticosteroid preparations as well as the cases of Crohn's disease and rheumatoid arthritis administered anti-TNF-alpha among compromised hosts. In diabetics, chemoprophylaxis is necessary for those who show healing of TB despite there being no history of TB treatment. Where a corticosteroid preparation, more than 10 mg in terms of prednisolone is administered over a long period of time for collagen disease and lung cancer, chemoprophylaxis is necessary for those who show healing of TB despite there being no history of TB treatment and those who are suspected of having TB infection by a tuberculin test. In the cases of Crohn's disease and rheumatoid arthritis administered anti-TNF-alpha, chemoprophylaxis is necessary for those who show healing of TB despite those who are suspected of having TB infection by a tuberculin test. The administration period of INH as chemoprophylaxis should preferably be set at 9 months instead of 6 months hitherto used.
Yamagishi
Fumio
F
Department of Respiratory Diseases, National Chiba-Higashi Hospital, 673, Nitona-cho, Chuo-ku, Chiba-shi, Chiba 260-8712, Japan. yamagisf@chibae.hosp.go.jp
D019072:Antibiotic Prophylaxis; D000995:Antitubercular Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid; D003095:Collagen Diseases; D003424:Crohn Disease; D003920:Diabetes Mellitus; D006801:Humans; D016867:Immunocompromised Host; D007538:Isoniazid / Q000008:administration & dosage*; D008175:Lung Neoplasms; D009363:Neoplasm Proteins / Q000009:adverse effects; D011239:Prednisolone / Q000009:adverse effects; D047889:Receptors, Tumor Necrosis Factor, Type II; D013997:Time Factors; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000517:prevention & control*; D053319:Tumor Necrosis Factor Decoy Receptors
D000995:Antitubercular Agents; D009363:Neoplasm Proteins; D047889:Receptors, Tumor Necrosis Factor, Type II; D053319:Tumor Necrosis Factor Decoy Receptors; D011239:Prednisolone; D007538:Isoniazid