Prevalence, screening and treatment of latent tuberculosis among oral corticosteroid recipients.

Tuberculosis guidelines identify individuals receiving the corticosteroid drug prednisone (or its equivalent) at a dose of .15 mg?day for 2–4 weeks or more as a group at risk of tuberculosis if infected with Mycobacterium tuberculosis [1, 2]. There is an eight-fold increased risk of developing active tuberculosis with such drugs at this dose [3]. However, there is no information on the epidemiology of latent tuberculosis infection (LTBI), screening and treatment among oral corticosteroid users. Tuberculosis guidelines recommend using a threshold of o5 mm induration to identify latent infection among oral corticosteroid recipients [1, 2] but this recommendation is not evidence-based. The purpose of this study was to describe the prevalence, screening and treatment of LTBI among oral corticosteroid recipients in the USA.