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July 3, 1996

Preventive Therapy for Multidrug-Resistant Tuberculosis-Reply

Author Affiliations

Centers for Disease Control and Prevention Atlanta, Ga

JAMA. 1996;276(1):28. doi:10.1001/jama.1996.03540010030017

In Reply.  —From a public health perspective, preventing the emergence and transmission of MDR TB in the community through the measures we described is more effective than trying to prevent the development of active TB in those individuals already infected. However, we acknowledge that managing patients infected with isoniazid- and rifampin-resistant strains of Mycobacterium tuberculosis, for which there is no demonstrable effective preventive therapy, is difficult and needs consideration.In answer to Dr Kirkland's questions: First, the CDC's recommendations for the management of persons exposed to MDR TB have not changed since their 1992 publication.1 We continue to strongly recommend alternative preventive therapy (ie, multidrug regimens with drugs other than isoniazid or rifampin) for contacts of MDR TB patients who have (1) a high likelihood of having been infected with the drugresistant M tuberculosis strain and (2) a high likelihood of progressing to active TB. The possibility of preventive therapy