LIMITED TOLERANCE OF OF OFLOXACIN AND PYRAZINAMIDE PROPHYLAXIS IN HEALTH-CARE WORKERS FOLLOWING EXPOSURE TO FAMPIN-ISONIAZID-STREPTOMYCIN-ETHAMBUTOL-RESISTANT TUBERCULOSIS

late October 1991, nosocomial rifampin-isoniazid-streptomycin-ethambut ol (RISE)-resistant tuberculosis began to spread in our institution. W e investigated prophylaxis with ofloxacin and pyrazinamide for those h ealth care workers whose tuberculin skin test converted after exposure to patients with RISE-resistant tuberculosis. Tolerance and completio n rates for 16 such persons were compared with a group of 34 workers r eceiving isoniazid preventive therapy. In the first group, compliance was lower and adverse reactions were significantly more likely than in the isoniazid group. In the doses used, ofloxacin and pyrazinamide we re poorly tolerated by health care workers in our institution. Because of the paucity of suitable alternatives, attempts at prophylaxis with a quinolone and pyrazinamide should still be considered. Alternative dosing regimens or other agents should be evaluated for preventive the rapy for isoniazid-, multidrug-, or RISE-resistant tuberculosis.