PERSONAL HEALTH : Common Errors Causing TB Woes?

The alarming rise in the number of tuberculosis cases that are resistant to standard antibiotic drugs may be caused in part by common errors doctors make in treating TB patients, according to a report in the Journal of the American Medical Assn.

The study, by Denver infectious-disease specialists Artin Mahmoudi and Michael D. Iseman, examined the cases of 35 patients. In 28 cases, the authors conclude, doctors and other health-care personnel made an average of four potentially significant errors during treatment.

The most common mistakes included giving a patient only one antibiotic when four are needed for maximum effectiveness; delaying drug therapy; giving drugs for too short a time or at too low a dose to be effective; failing to recognize drug-resistant infections and failing to deal with patients who do not take their medication.

The authors reviewed the records of patients with drug-resistant TB who were admitted to Denver’s National Jewish Center for Immunology and Respiratory Medicine in 1989 and 1990. They compared the way the patients’ cases had been handled with clinical standards for treatment defined by the federal Centers for Disease Control, the American Thoracic Society and the American College of Chest Physicians.