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The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993

We have compared the management of 925 cases of pulmonary tuberculosis reported to the 1993 national tuberculosis notification survey with the recommended standards of treatment. Forty-eight per cent of patients were white, 36% came from the Indian subcontinent (ISC) and 15% were of other ethnic ori...

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Autores principales: Ormerod, L P, Bentley, C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Physicians of London 1997
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421056/
https://www.ncbi.nlm.nih.gov/pubmed/9409502
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author Ormerod, L P
Bentley, C
author_facet Ormerod, L P
Bentley, C
author_sort Ormerod, L P
collection PubMed
description We have compared the management of 925 cases of pulmonary tuberculosis reported to the 1993 national tuberculosis notification survey with the recommended standards of treatment. Forty-eight per cent of patients were white, 36% came from the Indian subcontinent (ISC) and 15% were of other ethnic origin. Most patients (86%) were under the care of thoracic physicians. Sputum microscopy was positive in 44%, and culture confirmation was obtained in 64% of cases. Drug resistance was reported in 30/582 isolates (5%), ranging from 13% in Black-Africans to 4.5% in ISC ethnic groups and 2% in the whites, with none reported in those of Black-Caribbean origin. Almost all patients (94.5%) were started on a recommended drug combination, but only 74% continued to receive one, with thoracic physicians significantly more likely than other physicians to use a recommended combination. Non-standard durations of either initial and/or continuation phase therapy were used in 303 patients, but in only 167 was a satisfactory reason given for the modification. Definite or suspected drug toxicity was reported in 79 (9%) and was significantly more likely with non-standard regimens. Seventy-two patients died before the survey was carried out one year after their notification, only 15 of them directly due to tuberculosis. Of the 815 cases observed to treatment completion, 430 (53%) were then discharged. There were adequate reasons for follow-up after the end of treatment in all but 98 of those so managed. Although the results were satisfactory overall, continued efforts are required to increase the percentage of patients treated with evidence-based recommended regimens and durations of chemotherapy.
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spelling pubmed-54210562019-01-22 The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993 Ormerod, L P Bentley, C J R Coll Physicians Lond Original Papers We have compared the management of 925 cases of pulmonary tuberculosis reported to the 1993 national tuberculosis notification survey with the recommended standards of treatment. Forty-eight per cent of patients were white, 36% came from the Indian subcontinent (ISC) and 15% were of other ethnic origin. Most patients (86%) were under the care of thoracic physicians. Sputum microscopy was positive in 44%, and culture confirmation was obtained in 64% of cases. Drug resistance was reported in 30/582 isolates (5%), ranging from 13% in Black-Africans to 4.5% in ISC ethnic groups and 2% in the whites, with none reported in those of Black-Caribbean origin. Almost all patients (94.5%) were started on a recommended drug combination, but only 74% continued to receive one, with thoracic physicians significantly more likely than other physicians to use a recommended combination. Non-standard durations of either initial and/or continuation phase therapy were used in 303 patients, but in only 167 was a satisfactory reason given for the modification. Definite or suspected drug toxicity was reported in 79 (9%) and was significantly more likely with non-standard regimens. Seventy-two patients died before the survey was carried out one year after their notification, only 15 of them directly due to tuberculosis. Of the 815 cases observed to treatment completion, 430 (53%) were then discharged. There were adequate reasons for follow-up after the end of treatment in all but 98 of those so managed. Although the results were satisfactory overall, continued efforts are required to increase the percentage of patients treated with evidence-based recommended regimens and durations of chemotherapy. Royal College of Physicians of London 1997 /pmc/articles/PMC5421056/ /pubmed/9409502 Text en © Journal of the Royal College of Physicians of London 1997 http://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) , which permits non-commercial use and redistribution provided that the original author and source are credited.
spellingShingle Original Papers
Ormerod, L P
Bentley, C
The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993
title The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993
title_full The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993
title_fullStr The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993
title_full_unstemmed The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993
title_short The Management of Pulmonary Tuberculosis Notified in England and Wales in 1993
title_sort management of pulmonary tuberculosis notified in england and wales in 1993
topic Original Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421056/
https://www.ncbi.nlm.nih.gov/pubmed/9409502
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