To the Editor.—
I wish to point out an omission from advice given by Lees in QUESTIONS AND ANSWERS (237:1151, 1977). In discussing the management of a patient with recurrent episodes of cough and blood-streaked sputum after a thoracoplasty for tuberculosis 30 years previously, Lees made no reference to whether or not the patient had ever received chemotherapy. Former tuberculosis patients, such as the one described, are at higher risk of relapse if they have never had chemotherapy. For this reason, in addition to the management outlined, preventive therapy with isoniazid in a dose of 300 mg daily for one year should be offered to such a patient.1
Farer LS. Chemotherapy for Tuberculosis. JAMA. 1977;238(5):397. doi:10.1001/jama.1977.03280050037006
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