The duration of excretion of viable bacilli in elderly patients on treatment for cavitating pulmonary tuberculosis.
OBJECTIVE
To determine the period of excretion of viable tubercle bacilli in cavitating pulmonary tuberculosis in elderly patients while on treatment.


METHODS
10 consecutive black hospital inpatients over the age of 65 years (6 men, 4 women) with positive acid-fast bacilli smears and Lowenstein-Jenssen culture-proven pulmonary tuberculosis and radiological cavitation had weekly smears and cultures until at least three smears or two cultures were negative.


METHODS
Supervised treatment comprising rifampicin, pyrazinamide, ethambutol and isoniazid.


RESULTS
It look an average of 5.7 weeks (range 4-9 weeks) for the cultures and 8.2 weeks (range 4-14 weeks) for the smears to become negative.


CONCLUSIONS
Patients with cavitating pulmonary tuberculosis continue to excrete viable tubercle bacilli for approximately 6 weeks despite supervised treatment. It is suggested that allowing such patients back into an environment where three are immunocompromised subjects (e.g. elderly people in retirement homes or HIV-positive subjects) is probably hazardous until the patients are culture or smear negative.
Morris
C D
CD
Department of Medicine, Frere Hospital, East London, E. Cape.
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D044383:Black People; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000382:microbiology* / Q000635:transmission
D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin