Isoniazid-resistant tuberculosis. A community outbreak and report of a rifampin prophylaxis failure

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Abstract
The choice of effective preventive treatment for persons exposed to Mycobacterium turberculosis 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, was used for prophylaxis in contacts of cases with known isoniazid-resistant organisms. A community outbreak of isoniazid-resistant tuberculosis infection and a case of rifampin prophylaxis failure with acquired rifampin resistance were described. This raised concern about the efficacy of rifampin for the preventive treatment of contacts exposed to isoniazid-resistant tuberculosis.