With shortages of isoniazid, a major treatment for tuberculosis, expected to continue, the U.S. Centers for Disease Control and Prevention has expanded its general guidance to clinicians on how to adjust to a lack of the drug.
The CDC recently announced that the forecast date for restoring isoniazid production has been extended from January to as late as March. The agency said that the forecasts vary from producer to producer, but ultimately, the shortage is expected to continue.
While isoniazid remains scare, the CDC recommends clinicians coordinate their treatment plans for both active and latent TB with their jurisdictional public health officials. Those officials should set priorities for how existing stocks should be used according to the medical needs of individuals and general control strategy.
Patients with active TB should be treated first, followed by those with latent TB identified during contact tracing of contagious TB, followed by latent TB patients who face the greatest likelihood of progressing to TB disease. Treatment for those with latent TB can be postponed, but a system should be developed so that they can be recalled when isoniazid becomes more readily available.
The CDC is currently working with the U.S. Food and Drug Administration, the National Tuberculosis Controllers Association and two isoniazid producers to determine current stocks and options for restoring supplies as soon as possible.