Good riddance?

This week we suspended our tuberculin skin test program for healthcare workers due to the nationwide shortage of tuberculin. I say, Glory Hallelujah! I can't think of a more poorly performing test. Really, it's junk. And we've reached a point at our hospital that no healthcare worker will take isoniazid after a positive skin test until an interferon-gamma release assay has been done and is positive. However, there doesn't appear to be a good correlation between the skin test and the IGRA, so when the two tests are discordant, it's a coin toss as to which is the true result. To complicate matters even more, there's also a nationwide shortage of isoniazid. And don't even get me started on the use of isoniazid to treat latent TB (see here).

Photo:  Mayo Clinic