title: Survey of French physician practices in treatment and control of transmission of smear-positive tuberculosis.
abstract: OBJECTIVE
  To evaluate isolation practices and management of sputum smear-positive tuberculosis (TB) in France.
  
  
  METHODS
  A survey was conducted using a questionnaire e-mailed in 2011 and 2012 to physicians of the French Society of Infectious Diseases, the French Respiratory Society and the French National Society of Internal Medicine.
  
  
  RESULTS
  Of 311 responders, a quarter stated they treated more than 25 TB cases per year. A total of 87.8% declared they routinely used a four-drug regimen in the initial intensive phase. Of the 311 physicians who responded, 31.9% removed isolation precautions after three negative acid-fast bacilli (AFB) sputum results, 19.0% after 15 days of treatment and 34.1% only in case of clinical improvement. According to 71% of the responders, discharge from hospital despite positive AFB sputum smear results was 'possible'. A routine AFB sputum smear was performed after 2 months of treatment by only 21% of the responders.
  
  
  CONCLUSIONS
  Despite recent national guidelines, the management of isolation precautions for sputum smear-positive TB remains heterogeneous, and a significant proportion of physicians use a three-drug regimen. Further efforts should be made to implement TB guidelines, mainly by raising awareness through national scientific institutions, but also by obtaining better evidence.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Université Paris 13, Bobigny, France.
authors.forename: F
authors.initials: F
authors.lastname: Méchaï
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Université Paris 13, Bobigny, France.
authors.forename: J
authors.initials: J
authors.lastname: Figoni
authors.affiliation: Service des Maladies Infectieuses et Tropicales, APHP, Hôpital Bicêtre, Le Kremlin Bicêtre, France.
authors.forename: B
authors.initials: B
authors.lastname: Wyplosz
authors.affiliation: Centre Médical des Armées de Colmar, Colmar, Haut-Rhin, France.
authors.forename: O
authors.initials: O
authors.lastname: Aoun
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Université Paris 13, Bobigny, France.
authors.forename: O
authors.initials: O
authors.lastname: Bouchaud
authors.affiliation: Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, APHP, Hôpitaux Universitaires Pitié-Salpêtrière, Paris, France; Unité 1135, Centre d'Immunologie et des Maladies Infectieuses, Université Paris 06, Université Pierre et Marie Curie, Sorbonne Universités, Paris, France; Unité 1135, Centre d'Immunologie et des Maladies Infectieuses, Institut National de la Santé et de la Recherche Médicale, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Robert
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005602:France; D019538:Health Care Surveys; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013183:Sputum / Q000382:microbiology*; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000995:Antitubercular Agents