What sort of monitoring is needed during treatment?
• The CDC recommends monthly clinic visits during treatment to assess adherence and identify signs or symptoms of adverse drug reactions. Treatment should be held if the patient develops anorexia, nausea, vomiting, abdominal pain, dark urine, jaundice, rash, persistent fatigue, easy bruisability, or paresthesias of the hands and feet. Patients should be advised to refrain from alcohol ingestion during treatment. • Hepatitis is the most important adverse effect of latent TB treatment. It usually occurs within the first three months of treatment, and people with advanced age or daily alcohol consumption are at greatest risk. Overall incidence of hepatotoxicity is 0.1% with isoniazid and 0.6% with rifampin. • Peripheral neuropathy is another known adverse effect of isoniazid. The incidence is under 0.2%, and those at highest risk are pregnant and breastfeeding women, diabetics, alcoholics, HIV patients, and patients with uremia. Pyridoxine supplementation should be provided to these high-
