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[Prevention of tuberculosis for the immunocompromised host with biological agents and corticosteroid]

Makoto Miki1

  • 1Department of Respiratory Medicine, Japanese Red Cross Sendai Hospital.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|August 16, 2011
PubMed

Immunosuppressive drugs, such as corticosteroid and biological agents, inhibit the cell-mediated immunity and the granuloma formation against Mycobacterium tuberculosis. The rate of infection increases in patients given a daily dose of > or = 10 mg or a cumulative dose of > or = 700 mg of prednisone, and those patients need for the prevention of tuberculosis. Active tuberculosis may also develop after the initiation of TNFalpha inhibitors among biological agents. Before prescribing these immunosuppressive drugs, physicians should screen patients for latent tuberculosis infection or active disease with examining chest X-ray and CT, skin tuberculin test, and Quantiferon. The isoniazid daily regimen for 6-9 month is recommended for prevention, and rifampicin daily regimen for 4-6 month should be prescribed for the suspicious cases of isoniazid resistant.

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