Asunto(s)
Antiinfecciosos/uso terapéutico , Manejo de la Enfermedad , Enfermedades Pulmonares/terapia , Infecciones por Mycobacterium no Tuberculosas/terapia , Guías de Práctica Clínica como Asunto , Neumología , Sociedades Médicas , Humanos , Enfermedades Pulmonares/microbiología , Micobacterias no Tuberculosas/aislamiento & purificación , Reino UnidoRESUMEN
The full guideline for the management of non-tuberculous mycobacterial pulmonary disease is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline.
Asunto(s)
Tuberculosis/diagnóstico , Adolescente , Adulto , Anciano , Niño , Preescolar , Trazado de Contacto , Diagnóstico Precoz , Emigración e Inmigración , Personal de Salud , Humanos , Huésped Inmunocomprometido , Lactante , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/tratamiento farmacológico , Persona de Mediana Edad , Prueba de Tuberculina , Tuberculosis/tratamiento farmacológico , Adulto JovenRESUMEN
Guidelines have been compiled by the Joint Tuberculosis Committee of the British Thoracic Society for the prevention and management of Mycobacterium tuberculosis infection and disease in patients with all grades of renal impairment.
Asunto(s)
Infecciones Oportunistas/terapia , Insuficiencia Renal Crónica/complicaciones , Tuberculosis/terapia , Adulto , Profilaxis Antibiótica/efectos adversos , Profilaxis Antibiótica/métodos , Antituberculosos/efectos adversos , Antituberculosos/uso terapéutico , Medicina Basada en la Evidencia/métodos , Humanos , Tuberculosis Latente/complicaciones , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/terapia , Tamizaje Masivo/métodos , Infecciones Oportunistas/complicaciones , Infecciones Oportunistas/diagnóstico , Insuficiencia Renal Crónica/terapia , Terapia de Reemplazo Renal/métodos , Tuberculosis/complicaciones , Tuberculosis/diagnósticoRESUMEN
BACKGROUND: This paper presents the methods and findings of a survey of current service configuration in tuberculosis screening, treatment and prevention in England and Wales, which was conducted as part of the development of the National Institute for Health and Clinical Excellence guidelines on tuberculosis for the country. METHODS: A random sample of health protection units (HPUs) was surveyed (stratified geographically) in England. For Wales, National Health Service boundaries were used. There was a 100% sample of HPUs (33 clinics) in London and a 50% sample (81 clinics) outside London. The survey was completed by nurses in tuberculosis clinics. The questionnaire asked for details of caseload in terms of active disease (notified cases) and latent infection (screening and chemoprophylaxis), and the different types of specialist tuberculosis services offered. RESULTS: Completed surveys were obtained from 67 of 81 clinics outside London and all 33 clinics in London. An association was found between the number of notifications and personnel, in line with previous British Thoracic Society guidelines. Higher notification areas, especially in London, provide additional specialist services such as human immunodeficiency virus/tuberculosis clinics and specialist paediatric clinics. Clinics in London also reported higher usage of incentives, directly observed therapy (DOT) and free prescriptions. Low notification areas outside London tend to see more patients at home for contact tracing and treatment review. However, there is considerable variation in the use of DOT and chemoprophylaxis that is not entirely explained by differences in caseload. CONCLUSIONS: The survey showed that service configuration was organized in different ways in both high and low incidence areas. There is a need to share good practice and explore ways to configure services effectively in line with local needs.