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Isoniazid Preventive Therapy-Reply

Timothy R. Sterling, MD; Walter T. Brehm, MS
Arch Intern Med. 1996;156(7):811. doi:10.1001/archinte.1996.00440070145018.
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The impact of isoniazid-induced hepatitis fatality on the analysis of isoniazid preventive therapy for recent tuberculin converters who are older than 35 years is actually quite small. If one uses the fatality rates suggested by Salpeter in our analysis, the life expectancy of a tuberculin converter is improved by 1 day. Since our analysis already favors the use of isoniazid preventive therapy for recent tuberculin converters, this information does not affect the results or conclusions of our analysis.

The effectiveness of isoniazid is most affected by patient compliance. Isoniazid effectiveness is different from, and lower than, isoniazid efficacy, which may approach 100%. As we stated in our article, the extent to which isoniazid is active against isoniazid-resistant organisms is unknown and therefore could not be quantified for our analysis.


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