What is the appropriate next step for an RN with a positive PPD and a negative CXR?

The appropriate next step for a registered nurse with a positive PPD (Purified Protein Derivative) test and a negative chest X-ray (CXR) is to offer 6 months of Isoniazid (INH) treatment. A positive PPD indicates that the individual has been exposed to the tuberculosis (TB) bacterium, while a negative CXR suggests that there is no active pulmonary TB disease present.

In cases of a positive PPD with a negative CXR, the patient is typically classified as having latent TB infection (LTBI), which means the TB bacteria are inactive in the body and not causing symptoms. However, LTBI can reactivate and lead to active TB disease if left untreated, especially in individuals who may be at higher risk due to various factors such as immunocompromised status or other health conditions.

Isoniazid is an effective first-line medication for the treatment of LTBI, and the standard treatment duration is usually 6 to 9 months, with 6 months being an acceptable option and often preferred due to better adherence and fewer side effects. Administering INH helps prevent the progression to active TB disease and is a recommended standard in managing a patient with a positive PPD and negative CXR