De-isolation of patients with pulmonary tuberculosis after start of treatment - clear, unequivocal guidelines are missing.
The study review guidelines on isolation of patients with tuberculosis, TB, from the World Health Organization, WHO, Centers for Disease Control and Prevention, CDC, and the European Center for Disease Control, ECDC. The review found that unequivocal guidelines for removing patients out of negative-pressure isolation and de-isolation patients from either single rooms or isolation at home is needed. Studies show that the time of effective treatment is the key parameter to follow to determine if patients are contagious to others or not. This means that standard treatment of multi-drug resistant, MDR, TB will not result in the patient being non-infectious. Thus it is important right from the time of diagnosis to know if the patient is infected with MDR TB or not. Thus the early use of molecular techniques to reveal drug susceptibility is important. Clear guidelines stating if patient with microscopy negative sputum no matter infected with fully susceptible or MDR TB, no matter HIV positive or not is needed.
Institute of Clinical Medicine, University of Aarhus, Denmark; Department of Infectious Diseases, The Royal Hospital, Muscat, Oman. Electronic address: eskildp@dadlnet.dk.
Eskild
E
Petersen
Department of Infectious Diseases, The Royal Hospital, Muscat, Oman.
Faryal
F
Khamis
WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute Tradate, Italy.
Giovanni Battista
GB
Migliori
Department of Infectious Diseases, Aarhus University Hospital, Denmark.
Julie Glerup
JG
Bay
The Children's Hospital at Westmead and Centre for Research Excellence in Tuberculosis (TB-CRE), Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Australia.
Ben
B
Marais
Department of Infectious Diseases, Aarhus University Hospital, Denmark; Center for Global Health - Department of Health Services Research, Aarhus University, Denmark.
Christian
C
Wejse
Center for Clinical Microbiology, Division of Infection and Immunity, University College London, and the National Institute of Health Research Biomedical Research Centre at UCLHospitals, London, United Kingdom.
Alimuddin
A
Zumla
D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D010356:Patient Isolation / Q000592:standards; D017410:Practice Guidelines as Topic; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000628:therapy*; D014481:United States; D014944:World Health Organization
D000995:Antitubercular Agents
De-isolation; Isolation; Molecular diagnosis; Tuberculosis