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Editorials |

Consider Rifampin BUT Be Cautious

David Ashkin, MD; Joanne Julien, MD; Michael Lauzardo, MD; Elena Hollender, MD
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Affiliations: Lantana, FL
 ,  The authors are State Tuberculosis Health Officers for the Florida Bureau of Tuberculosis and Refugee Health and are affiliated with the A. G. Holley State TB Hospital.

Correspondence to: David Ashkin, MD, A. G. Holley State TB Hospital, 1199 West Lantana Rd, Lantana, FL 33462; e-mail: david_ashkin@doh.state.fl.us



Chest. 2006;130(6):1638-1640. doi:10.1378/chest.130.6.1638
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The majority of cases of active tuberculosis stem from patients with latent tuberculosis infection (LTBI). Treatment of this population is essential in order to achieve the goal of tuberculosis reduction and elimination. Approximately 40 years ago, the United States adopted the treatment of LTBI as a primary strategy to prevent tuberculosis disease and essentially rejected the broad-scale use of the bacille Calmette-Guín vaccine. Ironically, bacille Calmette-Guérin is the most widely used viable vaccine in the world, with > 3 billion doses administered globally. The decision not to use the vaccine in the United States was based on the epidemiologic observation that tuberculosis has a relatively low prevalence in the United States, and the fact that the vaccine is ineffective for the prevention of pulmonary tuberculosis in adults.1

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