Shifting tuberculosis care to the general hospital

Control of tuberculosis infection within the hospital is of major importance to general hospitals that assume the responsibility for providing tuberculous patients with primary care services. Because patients vary in their potential infectiousness, each patient's disease should be assessed individually. Patients who have completed a prescribed course of treatment are not infectious, and no precautionary measures are indicated. Patients with positive sputum who are receiving chemotherapy are rarely infectious, but they should be lodged in a room with air control. Effective antituberculous chemotherapy and adequate ventilation of the environment are the most important means of achieving infection control. Each hospital should have an infection control committee that is responsible for implementing infection control policies and for ensuring that patients with tuberculosis receive high-quality medical care. Educating personnel about tuberculosis, providing necessary consultation services, and making sure that patients are referred properly at discharge are important functions of the committee. Only those hospitals that are willing to meet these minimum standards should assume this responsibility.