[Current status of the criteria for discharging patients with pulmonary tuberculosis--results of questionnaire survey on the criteria for discharging patients from tuberculosis wards of the hospitals in Kanto area].
BACKGROUND
Emphasis in treating patients with infectious pulmonary tuberculosis has come to be laid on the execution of reliable standard chemotherapy. As a result, hospitalization for a prolonged period has become unnecessary any more. However, few attempts have been made so far on the determination of discharging criteria.


METHODS
We performed a questionnaire survey to hospitals with wards for tuberculosis in Kanto area and asked questions on the current status of discharging criteria.


RESULTS
The effective response rate to the survey was 63.0 %. Sputum smear examination carried out mainly by Ziehl-Neelsen method and fluorescence method in 17.2% and 72.4 % of the hospitals, respectively. Sputum culture examination was carried out using mainly Ogawa medium and a liquid medium in 62.1% and 27.6% of the hospitals, respectively. Discharging criteria were standardized in 79.3% of hospitals. Negative sputum smear was used as the criterion for determining discharge in 11 sets of criteria. Negative sputum culture was used as the criterion for determining discharge in 17 sets of criteria. In the remaining one hospital, patients were to be discharged after 2-month treatment. There was no consistency in the procedure and the frequency of sputum examinations, how many negative results are needed to confirm negative status and the criteria for judgment.


CONCLUSIONS
These results suggest that further evaluation must be made on the treatment outcome at each hospital, and the standard discharging criteria should be worked out taking into account the capacity of each hospital and the care situation of local community.
Division of Respiratory Disease, Kawasaki City Ida Hospital, Kanagawa, Japan.
Naoshi
N
Yanagisawa
Hisato
H
Shimada
Motofumi
M
Rinn
Kazumi
K
Nishio
Hirotoshi
H
Aoki
Masamitsu
M
Takahashi
D006757:Hospital Units; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000706:statistics & numerical data; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010351:Patient Discharge / Q000592:standards*; D012015:Reference Standards; D013183:Sputum / Q000382:microbiology; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology