New recommendations for PPD

There are new recommendations for those patients who turn PPD positive in their adult life and have a normal CXR. This is now called “latent tuberculosis.”

The recommendation is as follows:
1) All patients regardless of age should be treated with Isoniazid (INH) for 9 months.
2) Precautions should be taken regarding liver dysfunction and liver enzymes should be followed monthly.
3) Patients should be monitored carefully if they are on Coumadin or other drugs metabolized in the liver.
Dosing for INH is as follows [5 mg/kg PO/IM qd x6-9mo]
Max: 300 mg/day; Alt: 15 mg/kg PO/IM 2x/wk if therapy directly observed, max 900 mg/dose;
Info: to prevent progression in PPD-positive pts; give on empty stomach