Skip to content

Research at St Andrews

Think TB! Is the diagnosis of pulmonary tuberculosis delayed by the use of antibiotics?

Research output: Contribution to journalArticle

Author(s)

S. E. Craig, H. Bettinson, C. A. Sabin, S. H. Gillespie, M. C. I. Lipman

School/Research organisations

Abstract

SETTING: Effective tuberculosis (TB) control requires prompt diagnosis of infectious cases through early suspicion of pulmonary TB in all subjects with suspected respiratory infection.

OBJECTIVE: To test our hypothesis that prior antibiotic treatment for presumed bacterial infection leads to a delay in diagnosing TB in a European country with low TB incidence.

DESIGN: Adults with culture-confirmed pulmonary TB at a single metropolitan centre were assessed for the impact of any previous antibiotic treatment on symptoms and the time to starting specific anti-tuberculosis treatment.

RESULTS: Of 83 patients, 42 (51%) received antibiotics prior to TB diagnosis, with symptomatic improvement reported in 20 of the 42 (48%) patients. This was unrelated to specific drug class. Although the median time to diagnosis in subjects receiving antibiotics was prolonged (P = 0.001), this was not predicted by treatment response. In 94% of cases, the initial chest radiograph was suggestive of TB infection.

CONCLUSION: Patients receiving antibiotics prior to TB confirmation experience a process-related delay in starting treatment. To minimise the risk of ongoing TB transmission, we propose that clinicians should include TB in their differential diagnosis and initiate simple, TB-focused investigations early on in the diagnostic process.

Close

Details

Original languageEnglish
Pages (from-to)208-213
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume13
Issue number2
Publication statusPublished - Feb 2009

    Research areas

  • pulmonary tuberculosis, antibiotics, delayed diagnosis, CARE-SYSTEM DELAYS, MYCOBACTERIUM-TUBERCULOSIS, PATIENT, FLUOROQUINOLONES, CLARITHROMYCIN, ENGLAND, WALES

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Mimicking in-vivo exposures to drug combinations in-vitro: anti-tuberculosis drugs in lung lesions and the hollow fiber model of infection

    Kloprogge, F., Hammond, R., Kipper, K., Gillespie, S. H. & Della Pasqua, O., 13 Sep 2019, In : Scientific Reports. 9, 8 p., 13228.

    Research output: Contribution to journalArticle

  2. A tuberculosis molecular bacterial load assay (TB-MBLA)

    Sabiiti, W., Mtafya, B. A., Alferes De Lima, D., Dombay, E., Baron, V. O., Azam, K., Orascova, K., Sloan, D. J. & Gillespie, S. H., 6 Sep 2019, (Accepted/In press) In : Journal of Visualized Experiments.

    Research output: Contribution to journalArticle

  3. Can phenotypic data complement our understanding of antimycobacterial effects for drug combinations?

    Kloprogge, F., Hammond, R., Copas, A., Gillespie, S. H. & Della Pasqua, O., 25 Aug 2019, In : Journal of Antimicrobial Chemotherapy. Advance article, 7 p.

    Research output: Contribution to journalArticle

  4. Toxicity related to standard TB therapy for pulmonary tuberculosis and treatment outcomes in the REMoxTB study according to HIV status

    Tweed, C. D., Crook, A. M., Dawson, R., Diacon, A. H., McHugh, T. D., Mendel, C. M., Meredith, S. K., Mohapi, L., Murphy, M. E., Nunn, A. J., Phillips, P. P. J., Singh, K. P., Spigelman, M. & Gillespie, S. H., 14 Aug 2019, In : BMC Pulmonary Medicine. 19, 9 p., 152.

    Research output: Contribution to journalArticle

  5. Model-based relationship between the molecular bacterial load assay and time-to-positivity in liquid culture

    Svensson, R. J., Sabiiti, W., Kibiki, G. S., Ntinginya, N. E., Bhatt, N., Davies, G., Gillespie, S. H. & Simonsson, U. S. H., 29 Jul 2019, In : Antimicrobial Agents and Chemotherapy. Early

    Research output: Contribution to journalArticle

Related by journal

  1. International Journal of Tuberculosis and Lung Disease (Journal)

    Stephen Henry Gillespie (Editor)
    2011

    Activity: Publication peer-review and editorial work typesEditor of research journal

Related by journal

  1. Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data

    MacPherson, P., Squire, S. B., Cleary, P., Davies, S., Wake, C., Dee, K., Walker, J., Farrow, S., McMaster, P., Woodhead, M., Sloan, D. J. & North West TB Audit Steering Committee, 1 Jun 2016, In : International Journal of Tuberculosis and Lung Disease. 20, 6, p. 778-785 8 p.

    Research output: Contribution to journalArticle

  2. Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings

    Sabiiti, W., Mtafya, B., Kuchaka, D., Azam, K., Viegas, S., Mdolo, A., Farmer, E., Khonga, M., Evangelopoulos, D., Honeyborne, I., Rachow, A., Heinrich, N., Ntinginya, N. E., Bhatt, N., Davies, G. R., Jani, I. V., McHugh, T. D., Kibiki, G., Hoelscher, M., Gillespie, S. H. & 1 othersPANBIOME (Pan-African Biomarker Expansion Programme) consortium, 1 Aug 2016, In : International Journal of Tuberculosis and Lung Disease. 20, 8, p. 1004-1009

    Research output: Contribution to journalArticle

  3. Tuberculosis in the time of Ebola: Obstacles and opportunities

    Sloan, D. J. & O'Dempsey, T. J., 1 Nov 2015, In : International Journal of Tuberculosis and Lung Disease. 19, 11, p. 1269 1 p.

    Research output: Contribution to journalEditorial

  4. Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes

    Sloan, D. J., Mwandumba, H. C., Kamdolozi, M., Shani, D., Chisale, B., Dutton, J., Khoo, S. H., Allain, T. J. & Davies, G. R., 1 Aug 2015, In : International Journal of Tuberculosis and Lung Disease. 19, 8, p. 904-911 8 p.

    Research output: Contribution to journalArticle

  5. Managing malaria in tuberculosis patients on fluoroquinolone-containing regimens: assessing the risk of QT prolongation.

    Singh, K., laurenzi, M., Brown, M. & Gillespie, S. H., Feb 2012, In : International Journal of Tuberculosis and Lung Disease. 16, 2, p. 144-149 6 p.

    Research output: Contribution to journalReview article

ID: 64212506