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February 6, 1967

Prophylaxis in Tuberculosis

Author Affiliations

Oklahoma City

JAMA. 1967;199(6):434. doi:10.1001/jama.1967.03120060132036

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To the Editor:—  This pertains to a question regarding prophylaxis in tuberculosis ( 197:1112,1966), which concerned an elderly woman whose husband had died of tuberculosis. Her chest film showed nothing abnormal. The tuberculin test was positive, with degree of induration not recorded. Isoniazid prophylaxis was advised, in which recommendation I concur. The consultant further advised that the patient should be followed up by periodic physical examinations and a chest roentgenogram quarterly for about three years and annually thereafter.I wish to comment about the routine of repeated x-ray films that is recommended, aside from the question of radiation. I believe this time-honored custom of frequently x-raying contacts where the source case has been removed is unrewarding. It probably had some justification in the prechemotherapy era. In our experience, the same goal is achieved by less film taking and a bit more attention to skin testing and the use of isoniazid.