The Effect of Acceptable and Adequate Outpatient Treatment on the Length of Hospitalization and on Readmission for Relapse or Reactivation of Pulmonary Tuberculosis

¹ Director of Public Health, San Francisco Department of Public Health; Director, Chest Clinic, San Francisco General Hospital

If currently available medications are properly prescribed and taken regularly, it is possible to successfully treat and "cure" at least 95 percent of patients with newly detected, initially treated, pulmonary tuberculosis. Prolonged isolation and prolonged inactivation of patients, at home or at hospital, is no longer necessary, because the majority of patients are rapidly converted to noninfectious: 76.5 percent of 1,306 patients were sputum-culture negative at the end of the second month of chemotherapy; this increased to 91.7 percent at the end of four months. At the end of two months of treatment, 92.4 percent of patients with minimal tuberculosis were sputum-culture negative, compared to 45.0 percent of patients with far advanced disease. At the end of four months of treatment, 96.8 percent of patients with minimal disease were sputum-culture negative, compared to 79.6 percent of patients with far advanced tuberculosis. Acceptable neighborhood clinics, improved patient cooperation, and strong emphasis on taking medications regularly as prescribed, were associated with a marked decrease in hospital readmissions, reactivations, and the development of secondarily resistant organisms.

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