Evidence base: Pulmonary tuberculosis

A summary of the evidence base for the management of pulmonary tuberculosis.

Chest X-ray showing widespread, ill-defined and nodular shadowing
Chest X-ray showing widespread, ill-defined and nodular shadowing

Clinical trials
The first randomised trial in medicine was of streptomycin in TB.3 This heralded a series of randomised trials in Europe, North America, Africa, India and Hong Kong which tested drugs, regimens and durations. Initially 18 months to two years,4 duration was reduced to nine months5 and eventually to six months with regimens based on rifampicin and isoniazid.6

Guidelines

  • NICE. Clinical diagnosis and management of tuberculosis, and measures for its prevention and control. London, NICE, 2011. Available from: www.nice.org.uk/guidance/CG117

Key texts

  • Caminero J. Pulmonary/pleural tuberculosis. In: Torres A, Ewig S, Mandell L et al (eds). Respiratory infections. First edition. London, Hodder Arnold, 2006.
  • Leitch A G. Pulmonary tuberculosis. In: Seaton A, Seaton D, Leitch AG (eds). Crofton and Douglas's Respiratory Diseases. Fifth edition. Oxford, Blackwell, 2000.

Curriculum
This topic is covered in the GP curriculum in statement 15.8 Respiratory Problems.

More online
Both the British Lung Foundation and TB Alert provide useful online resources, including information for patients:

  • British Lung Foundation www.lunguk.org/you-and-your-lungs/conditions-and-diseases/tuberculosis
  • TB Alert www.tbalert.org

 

Contributed by Dr Ian Campbell, honorary consultant physician, University Hospital Llandough, Cardiff, and Dr Matt Brouns, registrar in respiratory medicine, Nevill Hall Hospital, Abergavenny.

 

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