THE MANAGEMENT OF PULMONARY TUBERCULOSIS IN ADULTS NOTIFIED IN SCOTLAND IN 1993

The management of pulmonary tuberculosis (TB) in Scotland in 1993 was studied by asking the physicians responsible for all 321 adult cases o f the disease notified that year to complete a standardized questionna ire relating to drug treatment and bacteriology. The response rate to the questionnaire was 100%. Isoniazid and rifampicin were used togethe r in initial therapy in 98.4% of cases, while pyrazinamide was prescri bed in 90.3% of cases, broadly in keeping with existing treatment guid elines. However, considerable variability was observed both in the dru g regimens employed, and in the duration of initial and continuation p hases of chemotherapy. Treatment regimens were therefore frequently at variance with published recommendations. Among patients prescribed dr ug regimens other than those recommended satisfactory completion of th erapy was less common. Microbiological confirmation was provided for 8 4% of cases in which clinical samples were submitted. However, in appr oximately 11% of cases, no clinical samples were submitted. Closer adh erence to existing treatment guidelines and more rigorous pursuit of m icrobiological confirmation should further improve the overall managem ent of pulmonary TB in Scotland.