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A Community Outbreak and Report of a Rifampin Prophylaxis Failure

John R. Livengood, MD; Tudi G. Sigler, RN; Laurence R. Foster, MD, MPH; Jeannette G. Bobst, RN, MS; Dixie E. Snider, Jr, MD

JAMA. 1985;253(19):2847-2849.

Abstract
The choice of effective preventive treatment for persons exposed to Mycobacterium tuberculosis resistant to isoniazid is uncertain. Although no data document the efficacy of any drug other than isoniazid for preventive treatment of tuberculosis, rifampin, with or without ethambutol, has been used for prophylaxis in contacts of cases with known isoniazid-resistant organisms. This report describes a community outbreak of isoniazidresistant tuberculosis infection and a case of rifampin prophylaxis failure with acquired rifampin resistance. This raises concern about the efficacy of rifampin for the preventive treatment of contacts exposed to isoniazidresistant tuberculosis.

(JAMA 1985;253:2847-2849)

Author Affiliations
From the Division of Field Services, Epidemiology Program Office (Dr Livengood), and the Division of Tuberculosis Control, Center for Prevention Services (Dr Snider), Centers for Disease Control, Atlanta; the Lane County Health Division, Eugene, Ore (Mss Sigler and Bobst); and the Oregon Health Division, Portland (Dr Foster). Dr Livengood is an EIS Officer, Oregon Health Division, Portland.

Footnotes
Reprint requests to Office of Health Status Monitoring, Oregon Health Division, PO Box 231, Portland, OR 97207 (Dr Livengood).

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