Dr Lewin sites the report of a 10-year-old Portuguese girl (an immigrant to Canada), who developed neurotoxicity presenting as cerebellar ataxia, after receiving 300 mg/d of isoniazid (INH) for chemoprophylaxis. She completely recovered upon discontinuation of INH and treatment with pyridoxine therapy (50 mg/d).1 He recommends that all patients, including children, should be on prophylactic pyridoxine (15-50 mg/d) when taking INH. Dr Lewin also comments about chronic INH neurotoxicity becoming much more prevalent; however, this information is not supported by the literature.

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