Table 13 Isoniazid Preventive Therapy, (IPT)*
1994 American Thoracic Society / Centers for Disease Control Guidelines
| Condition |
Duration of IPT |
PPD |
Comments |
| HIV + or suspect |
12 months |
 5 mm induration
or regardless of PPD |
May give IPT to those at high risk of tubercu- losis infection by epidemiology
alone. |
| Close contact to newly diagnosed, infectious case |
6 months
|
 5 mm induration
or regardless of PPD |
IPT for infants/young children exposed; may stop if PPD remains negative
at 3 months. |
| Recent tuberculin conversion (in past two years) |
6 months
|
10 mm if < 35
years
15 mm if
35 years |
IPT for all PPD reactors < 4 years. Induration increases of 10mm or
> are significant. |
| Fibronodular scarring in lung apex |
12 months
|
5 mm induration
|
• Any age group
• Rule out active disease |
| Medical conditions with increased tuberculosis risk |
6 months
|
10 mm induration
|
IDDM, prolonged steroids, immunosup- pressive Rx, cancers, IDU, ESRD,
rapid loss of weight or mal- nutrition. |
| PPD reactor < 35 years old with racial, socio- economic or other non-
medical risk factors |
6 months
|
10 mm induration
|
• Foreign born, high risk area
• Disadvantaged poor/minority
• Residents of at risk facilities (NHs, correctional or psych) |
|
PPD reactor < 35 years old without special risk factors |
6 months
|
15 mm induration |
Consider risk-benefit on ad hoc basis |
| *Abbreviations: ESRD=end-stage renal disease;
HIV=human immunodeficiency virus; IDDM=insulin-dependent diabetis mellitis;
IDU=injection drug user; IPT=isoniazid preventive therapy; NHs=nursing homes;
PPD=purified protien derivative |