Productivity of prolonged follow-up after chemotherapy for tuberculosis.

Abstract

A review was made of the records of 530 patients with pulmonary tuberculosis who were released for ambulatory chemotherapy after achieving a culture-negative status with isoniazid and p-aminosalicylic acid, and streptomycin initially in some instances. Twenty-three of 39 relapses occurred in the first year and largely represented failures to take medication. Among 372 patients who had remained well for 3 years after receiving chemotherapy for 18 months or more, there were only 3 relapses (0.8 per cent of the total, or 0.12 per cent per year), whereas among 28 patients who had received less chemotherapy, there were 5 relapses (18 per cent) after 3 years. Early relapses were often detected in the follow-up clinic, but only 3 of those occurring later were so detected. Based on these observations, it is suggested that prolonged follow-up of successfully treated patients is not very productive, and that it would be better for chest clinics to give priority to close supervision of patients who are receiving mul...