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. 2025 Mar;31(3):633-636.
doi: 10.3201/eid3103.241473.

Evaluation of High-Dose Isoniazid in Multidrug-Resistant Tuberculosis Treatment

Valentina Gerussi, Tania Petersen, Isabelle Bonnet, Alexandra Aubry, Marwa Bachir, Esther Gyde, Florence Morel, Corentin Poignon, Brigitte Rached, Valérie Pourcher, Christophe Rioux, Dorothée Vallois, Nicolas Veziris, Jérôme Robert, Lorenzo Guglielmetti

Evaluation of High-Dose Isoniazid in Multidrug-Resistant Tuberculosis Treatment

Valentina Gerussi et al. Emerg Infect Dis. 2025 Mar.

Abstract

High-dose isoniazid is recommended to treat multidrug-resistant tuberculosis (MDR TB). Among 958 MDR TB isolates identified in France during 2008-2022, 93.1% exhibited high-level isoniazid resistance, and molecular testing showed limited diagnostic accuracy in predicting resistance. Clinicians should reconsider using high-dose isoniazid in MDR TB treatment because of suboptimal effect and toxicity concerns.

Keywords: MDR TB; SCR; antimicrobial resistance; bacteria; drug susceptibility testing; genotypic; hepatotoxicity; inhA; isoniazid; katG; mutation; phenotypic; respiratory infections; tuberculosis and other mycobacteria.

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Figures

Figure
Figure
Flowchart of MDR TB isolates identified in France during 2008–2022 included in an evaluation of high-dose isoniazid in MDR TB treatment. DST, drug susceptibility testing; MDR TB, multidrug-resistant tuberculosis; SCR, short-course regimen.
See this image and copyright information in PMC

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