Tuberculosis treatment: dangerous regimens?

The results of the USPHS Study are a warning of the potentially frightening consequences of functional monotherapy. While it remains a single study the question arises as to whether it is justified to await confirmatory studies before reconsidering recommendations for anti-tuberculosis treatment in national tuberculosis programs in low-income countries. We conclude that the utilization of isoniazid and rifampicin in the continuation phase should be discouraged in settings where second-line drugs are not routinely available for re-treatment of failures particularly if HIV infection is prevalent in the patient population and there is important resistance to isoniazid. (excerpt)