Proper care of persons infected with isoniazid-resistant tubercle bacilli is controversial because there are few data on the risks and benefits of the preventive treatment alternatives. Decision analysis was used to facilitate a comparison of outcomes using different strategies and the Delphi technique to obtain estimates of relevant probabilities. For all probabilities of isoniazid resistance, the observation and no-drug alternative is unsatisfactory because it would result in a twofold to sevenfold greater number of tuberculosis cases than any of the drug regimens. With a low probability of isoniazid resistance, isoniazid is the preventive treatment of least cost and proved efficacy. As the probability of isoniazid resistance increases, more cases are prevented by rifampin-containing regimens, but at added cost. These findings can be used to formulate appropriate preventive treatment recommendations.
Koplan JP, Farer LS. Choice of Preventive Treatment for Isoniazid-Resistant Tuberculous Infection: Use of Decision Analysis and the Delphi Technique. JAMA. 1980;244(24):2736–2740. doi:10.1001/jama.1980.03310240028018
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