Acetylator phenotype and short-course chemotherapy for tuberculosis in Papua New Guinea

In Papua New Guinea the slow acetylator phenotype is unusual and peripheral neuropathy during isoniazid therapy is uncommon. Acetylator status and other factors influencing isoniazid-induced peripheral neuropathy are discussed, and statistics from Papua New Guinea are presented. The relevance of acetylator phenotype to other side-effects of isoniazid is less well defined. Prophylactic pyridoxine supplementation during short-course chemotherapy for tuberculosis is not generally necessary in the daily 'A' regimen, but should be maintained in the twice-weekly (high-dose isoniazid) 'B' regimen for adults and children over 20 kg.