Physicians in the United States must maintain vigilance for the 25 000 annual new cases of tuberculosis, concentrated in the elderly, in immigrants, in migrant and minority populations, and in immunosuppressed patients. Tuberculosis rates in the South remain above the national average. Physicians diagnosing tuberculosis may also treat the disease, working with health departments, which can assist with drugs, follow-up tests, and contact investigation. Powerful short-course regimens have been standard treatments since 1986. The preferred combination is isoniazid, rifampin, and pyrazinamide daily for 2 months, followed by isoniazid and rifampin for 4 more months. A 9-month regimen of isoniazid and rifampin is equally effective. Supplementation or extension of these regimens is mandatory when drug resistance or immunosuppression, respectively, is likely. Isoniazid prophylaxis for 6 to 12 months continues to be a vital but often neglected preventive measure for those infected with Mycobacterium tuberculosis, but without active disease.

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symptomatology laboratory diagnosis Drug Resistance, Microbial demography human intramuscular drug administration sputum culture Mycobacterium tuberculosis priority journal Aged oral drug administration Acquired Immunodeficiency Syndrome intravenous drug administration Drug Administration Schedule drug administration liver function test United States liver toxicity Drug Interactions drug interaction False Negative Reactions Rifampin ototoxicity cellular immunity tuberculosis risk factor Risk Factors high risk population Article Drug Therapy, Combination disease transmission streptomycin major clinical study tuberculin test adult isoniazid drug safety thorax radiography antibiotic resistance ethambutol drug resistance rifampicin pyrazinamide bacterium culture acquired immune deficiency syndrome drug combination Radiography, Thoracic Child