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July 15, 1961

Chemotherapy for Child with Positive Tuberculin Reaction

JAMA. 1961;177(2):166. doi:10.1001/jama.1961.03040280070020

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To the Editor:—  Dr. Robert B. Clark, III, takes issue (JAMA176:73 [April 8] 1961) with a statement that children under 4 years of age "should be given 5 mg. of isoniazid per kilogram of body weight per day for one year or more," which appeared in the answer to the question concerning chemotherapy for a child with a positive tuberculin reaction (JAMA175:74 [Jan. 7] 1961). Dr. Clark feels that the dosage of isoniazid should be 3 times as high, and that paraaminosalicylic acid (PAS) should be given because many children inactivate isoniazid rapidly, and these 2 procedures would insure that rapid inactivators get adequate isoniazid therapy. He further recommends that it would be preferable to measure the serum level of active isoniazid after test doses and adjust the dose to produce an active isoniazid level higher than 0.4 mcg. per milliliter 6 hours after the dose.

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