ISONIAZID PROPHYLAXIS - THE IMPORTANCE OF INDIVIDUAL-VALUES

To provide insight into the decision whether to use isoniazid prophyla xis in uncomplicated cases of positive tuberculin tests, the authors c onducted a multicriteria decision analysis using the analytic hierarch y process. If reducing the chance of developing active tuberculosis is considered at least slightly more important than avoiding isoniazid-r elated side effects, isoniazid prophylaxis is the better strategy for all patients. If avoiding isoniazid-related side effects is considered at least slightly more important, no prophylaxis is the better strate gy for all patients. if these two considerations are judged equally im portant, the better strategy depends on patient age, the anticipated e ffectiveness of isoniazid prophylaxis, and whether or not the patient is a recent tuberculin convertor. The tradeoff between avoiding active tuberculosis and avoiding isoniazid-related side effects is the most important factor in the decision regarding the proper management of pa tients with positive tuberculin tests. These results emphasize the imp ortance of taking an individualized approach to the management of thes e patients.